DNP Project Implementation Results Discussion: Outcomes, Staff Engagement, DNP Leadership and Statistician Collaboration

DNP Discussion: Results of the DNP practicum project implementation

In preparation for writing the remaining chapters of your DNP project proposal, write about your overall experience with your DNP practicum project implementation. Appraise the experience by providing an overview of the results, staff engagement and participation, your role as a DNP leader and your collaboration with a statistician. Finally, describe your preparation leading up to implementation.

800 words. The rubric evaluates relevance and insight, quality of writing, inclusion of the DNP Essentials and role-specific competencies, scholarly references from the past five years, peer and professor responses and timeliness.

Original example for study purposes (about 830 words). The project and results are fictional.

Overall Experience

Implementing my DNP project, a nurse-driven Patient Health Questionnaire-9 (PHQ-9) depression screening protocol in a suburban primary care clinic, was the most demanding and rewarding part of my doctoral journey. Moving from planning to practice taught me that translating evidence into practice depends as much on people, workflows and communication as on the evidence itself. White et al. (2021) describe translation as a process of adapting evidence to a specific context, and I experienced this directly when our first workflow had to be revised after the first week because it slowed patient intake. Overall, the experience strengthened my confidence as a practice scholar and change agent.

Overview of the Results

Over the eight-week implementation period, the clinic screened adult patients at annual and chronic care visits. The proportion of eligible patients screened increased from a pre-implementation baseline of 38% (from a retrospective chart review of eight weeks) to 86% during implementation. Among patients with a PHQ-9 score of 10 or higher, documented follow-up within two weeks, such as a provider assessment, referral to behavioral health or a scheduled return visit, increased from 41% to 78%. A chi-square test showed that both improvements were statistically significant (p < .001). Staff also reported that the workflow became faster once the screening was integrated into the electronic health record intake template. These results suggest that a nurse-driven protocol can close an important gap in identifying and treating depression in primary care, although an eight-week project cannot show long-term patient outcomes such as symptom remission. [Replace with your results.]

Staff Engagement and Participation

Staff engagement was essential. I recruited two medical assistants and one registered nurse as unit champions, who helped design the workflow and modeled it for peers. All 14 clinical staff completed a 30-minute training session on the PHQ-9, scripting for introducing the screening and the escalation process for positive screens, including suicide risk. Early resistance centered on time pressure, so I shared weekly run charts at huddles to show progress and invited feedback, which led to two workflow improvements. Recognizing staff achievements publicly helped sustain participation. Providers initially worried about increased workload from positive screens, which we addressed by clarifying the referral pathway with the behavioral health team.

My Role as a DNP Leader

As the project leader, I acted as a facilitator, educator, coordinator and evaluator. The AACN (2021) Essentials emphasize competencies in quality and safety (Domain 5), interprofessional partnerships (Domain 6), systems-based practice (Domain 7) and leadership (Domain 10), and I drew on each. I used transformational leadership principles, sharing a clear vision of why depression screening matters, involving staff in decisions and coaching individuals, approaches associated with stronger safety culture and better outcomes in nursing (Ystaas et al., 2023). I also learned the importance of humility; listening to medical assistants’ concerns about workflow produced better solutions than my original plan.

Collaboration With a Statistician

Collaborating with a statistician strengthened the rigor of my evaluation. Before implementation, we reviewed my outcome measures and data collection tools to ensure that variables were clearly defined and that the sample size would be adequate for comparison. The statistician recommended a chi-square test for comparing pre- and post-implementation proportions and helped me plan for missing data. After data collection, we reviewed the output together, and the statistician helped me interpret statistical versus clinical significance and identify limitations, such as the lack of a control group and possible differences between the baseline and implementation populations. This collaboration taught me to plan the analysis before collecting data, not afterward.

Preparation Leading Up to Implementation

Preparation began months earlier with a needs assessment, including a chart audit and stakeholder interviews, that confirmed low screening rates. I completed a literature review, selected the evidence-based PHQ-9 tool and developed the protocol with the medical director and nurse manager. I obtained organizational approval and an Institutional Review Board determination that the project was quality improvement. I also created training materials, built the electronic health record template with the IT department, planned a data collection spreadsheet and conducted a one-week pilot to test the workflow. Using a logic model and implementation timeline kept the project organized and realistic (Zaccagnini & Pechacek, 2021).

Sustainability and Lessons Learned

Planning for sustainability became one of my most important lessons. Before the project ended, I worked with the nurse manager to embed the screening into the standard intake workflow, assign ongoing data monitoring to the clinic’s quality committee and add PHQ-9 training to new employee orientation. I also learned that small, early wins, shared visibly with staff, build momentum, while ignoring workflow concerns can quietly undermine even strong evidence. These insights will shape how I lead future quality improvement initiatives.

Conclusion

Implementing this project showed me that DNP leadership involves translating evidence, engaging people and evaluating outcomes rigorously. The experience prepared me to write the results and discussion chapters with a clear understanding of what worked, what did not and how the project could be sustained and expanded to other clinics.

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing.

Ystaas, L. M. K., Nikitara, M., Ghobrial, S., Latzourakis, E., Polychronis, G., & Constantinou, C. S. (2023). The impact of transformational leadership in the nursing work environment and patients’ outcomes: A systematic review. Nursing Reports, 13(3), 1271–1290. https://doi.org/10.3390/nursrep13030108

Zaccagnini, M. E., & Pechacek, J. M. (Eds.). (2021). The doctor of nursing practice essentials: A new model for advanced practice nursing (4th ed.). Jones & Bartlett Learning.

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