Read a selection of your colleagues’ responses, and respond to at least two of your colleagues on two different days by exploring the problems, references, and strategies. Offer suggestions and strategies that may enhance the design approach your colleague described.



Heather Rowell

Week 7 Discussion Post-Initial Post


            As a DNP, it is essential that when an identified practice problem exists that the proper strategies and leadership skills are used as appropriate for promotion of positive outcomes. As we are all aware there are challenges exist when trying to promote a change for the betterment of the organization as well as all other stakeholders involved. With the advancement of education and knowledge received as a DNP, there should be substantial information that can be used to assist in the guidance of being successful in the promotion of change and positive outcomes. The identified practice problem that I have identified within the organization is the lack of knowledge of the importance of depression screening in patients by the staff members which could results in a delay in treatment if needed for patients at risk for depression.

Identified Design Approach

            Identification of an appropriate design approach is vital for the promotion of change with the identified practice problem. Based on my identified practice problem, in my opinion, the best approach is to improve the knowledge of the staff members by providing education with the use of the screening tools for depression. One of the ways to approach this problem is by writing a SMART objective as the key to developing critical measurable objectives is having collectable data that are adequate for measuring change (Sipes, C. (2024). It is also important that the application of the use of clinical guidelines for depression screening is included in the approach.

Focus and Setting

            For my identified practice problem of the importance of additional staff education on depression screening, it is most relevant that the focus be on quality improvement and the use of gathering research on evidence that suggests a change is needed for the promotion of positive outcomes with patients and within the organization to ensure that quality measures are being met. Population health has changed throughout the years and the terminology of the population involves several groups including nations, communities, employees, ethnic groups, disabled persons, prisoners, patients, or organizations (Hickey, J. V., & Giardino, E. R. (Eds.). (2021). As related to my problem, the organization, employees, and patients are all within the group that would benefit for the change needed to improve outcomes.

Facilitators and Barriers

            With any practice problem that is identified, there are always going to be barriers that exist. In my practice problem, one of the barriers identified was bringing to attention the need for additional education on the importance of depression screening to staff members. The staff was aware of the depression screening tools used, however, there was a lack in the importance of when to complete it and how to relay the results if patients were identified at risk for depression so that they could be treated in a timely manner. There are several facilitators within the organization including the medical director, staff, and the quality measures specialist. All of these individuals play a role in the process of change to improve outcomes.


Leadership Styles and Skills

            Managing a research project can be very challenging and requires special skills to become a leader and overcome the barriers that may exist. Nurse leaders as researchers need to be able to conduct ethical research that meets the standards for rigor and integrity and be aware of the standards for quality research and methods for fostering quality; additionally, the main objective and goal is to produce evidence that is useful and suitable to translate to practice for optimal patient care and positive outcomes (Aycock, D. M., Clark, P. C., Thomas-Seaton, L., Lee, S.-Y., & Moloney, M. (2017). Additionally, as a DNP, part of our role as leaders is to maintain clinical practice, conduct program evaluations, implement practice changes and improvements, manage quality improvement, and translate evidence into practice (Sipes, C. (2024). My leadership style in this aspect, in my opinion, would be the transformational style as there is a need for change to transform the behaviors of the staff members to improve knowledge with the use of additional education on depression screening in patients.

Evidence Gathered

            One of the most important aspects of promoting change to an identified practice problem is to gather evidence that would assist in the understanding of why there is a need for the change. After obtaining research on the identified problem of depression screening, it was found that there is an issue with identification of patients at risk for depression and the need to use screening tools to identify these patients in a timely manner for appropriate treatment. According to one article there was a need for change in a primary care clinic within the vulnerable population in a rural area; additionally, a quality improvement design based on the plan-do-study-act (PDSA) model, charts a prescribed four-stage cyclic learning process while compatible with the Promoting Action on Research Implementation in Health Services Framework (PARiHS) model for evidence-based practice (Burge, S.A., Powell, W., & Mazour, L. (2019).


            It is vital that the DNP be prepared to identify practice problems that exist and develop strategies and leadership skills to make a difference within the organization. Change within any organization can be overwhelming and sometimes include challenges and barriers, however, as an advanced care provider, we should be able to develop strategies to overcome these barriers and challenges. As a leader, we are held accountable to provide development of designs and tools that can be used for a successful project outcome.



Burge, S.A., Powell, W., & Mazour, L. (2019). A quality improvement endeavor improving depression screening for rural older adults. 
Journal of Rural Nursing & Healthcare. 19(2): 44-64,

Hickey, J. V., & Giardino, E. R. (Eds.). (2021). 
Evaluation of quality in health care for DNPs (3rd ed.). Springer Publishing.

Chapter 8, “Planning a Program or Project Evaluation” (pp. 189–214)

Chapter 13, “Evaluation of Populations and Population Health” (pp. 329–350)

Sipes, C. (2024). 
Project management for the advanced practice nurse (3rd ed.). Springer Publishing Company.

Chapter 3, “Design/Initiation: Project Management—Phase I” (pp. 55–84)

Chapter 4, “Planning: Project Management—Phase 2” (pp. 85–130)

Aycock, D. M., Clark, P. C., Thomas-Seaton, L., Lee, S.-Y., & Moloney, M. (2017). 

Simple tools to facilitate project management of a nursing research projectLinks to an external site.Links to an external site.

Western Journal of Nursing Research
39(3), 430–443.

 ReplyReply to Comment




Molly Salmonsen

2:15pmJul 9 at 2:15pm

Manage Discussion Entry

Practice Problem

The practice problem I am addressing during this course is noncompliance with blood pressure management per CMS guidelines in patients suspected to have sepsis receiving fluid boluses in the ED. Current guidelines require 2 blood pressure measurements within the first hour after fluid bolus completion and the facility is finding that this guideline is not being met, however they are unsure why.

Design Approach

The design approach I feel would be most beneficial is to provide education to the nurses regarding the importance of BP monitoring in septic patients or those suspected to have sepsis who require IV fluid boluses. Using SMART objectives, I have been working with the facility to determine the specific goal (improving BP compliance to greater than 68%), which also ties into our measurable objective. We have also worked to make sure this goal is achievable and realistic within the department, and have developed time frames for measuring these goals, typically on a month-to-month basis to determine the progress and goal attainment (CDC, 2018).

Leadership Styles

Transformational leadership will be best utilized as it is used to help motivate workers to improve performance expectations. This is completed by intellectual stimulation, showing consideration for staff, helping motivate staff to work well and be autonomous and confident, and setting achievable goals for staff (National University, 2024).


Facilitators that will help support this goal is management, providers within the ED, and hospital administration. The organization first and foremost sets the stage for how successful a project can be. Management’s motivation to change and to support workers with the change is an important indicator for how successful a change in practice will be (Crawford et al., 2022).


Barriers include high nurse-to-patient ratios which can cause some things to “slip between the cracks” as it relates to blood pressure monitoring or other cares. Some other barriers may include technological issues, such as BP monitors not working or recording, or the patient being out of the ED for testing (CT scans, MRIs, etc.).


Centers for Disease Control and Prevention (CDC). (2018). 
Writing SMART objectives. 

to an external site.

Crawford, L., Maxwell, J., Colquhoun, H., Kingsnorth, S., Fehlings, D., Zarshenas, S., McFarland, S., & Fayed, N. (2022). Facilitators and barriers to patient-centred goal-setting in rehabilitation: A scoping review. 
Clinical rehabilitation
36(12), 1694–1704.

National University. (2024). 
What is transformational leadership?