I need these questions answered in 200 words each.
Topic 2
DQ 1
Learners in the DNP program are required to develop a Direct Practice Improvement (DPI) Project. Describe your proposed practice site and a potential patient practice problem that you are interested in exploring for your project. Explain why this is a valid topic for your practice site. How do you believe this project will contribute to the body of knowledge in your field?
DQ 2
Learners are expected to demonstrate scholarly writing throughout the program in all written work (discussion forum, assignments, final project). Reflect on writing your Scholarly Writing Using Research paper and consider which of the standards of scholarly writing are most challenging for you:
Identifying appropriate evidence for support (peer-reviewed and scholarly sources).
Writing in one’s own words and properly citing authors for ideas, findings, etc.
Writing in APA style.
Describe which is most challenging for you and why. What tools or sites did you use to address the challenges? What strategies will you use to become more proficient? (This response does not require research support.)
You are expected to use the principles of scholarly writing throughout the program without further prompting. Refer to the writing resources in the GCU Library and Student Success Center for ongoing assistance.?
Topic 3
DQ 1
Refer to the “Levels of Evidence in Research” document to assist in this discussion question.
Explain why research articles that fail to meet these criteria cannot be used to provide evidence for the DPI Project. Using these criteria, find two primary research articles for your proposed patient practice problem and explain why these are considered primary research articles and why they demonstrate support for your proposed nursing practice problem. Post the links with your references.
DQ 2
When writing in APA style, citations and references are used to give credit to the respective authors for their ideas or work. It is also preferred that ideas or work are summarized instead of using a direct quote to present the information. Explain what the difference is between a citation and reference, how using these properly will help you avoid the consequences of plagiarizing, and why a summary is preferred. How can LopesWrite help ensure you are effectively summarizing another author’s work (versus direct quotes)?
As an example, summarize and cite information from a primary research article that demonstrates support for your proposed intervention for your selected practice problem (three or four sentences).
Topic 4
DQ 1
In your own words, define critical thinking and explain why it is an important to you as a learner proposing a quality improvement project (DPI project) for your practice site. Discuss three critical thinking skills necessary for evaluating and interpreting primary quantitative research for a DPI Project.
DQ 2
Distinguish between quantitative and qualitative research. Explain why more quantitative research articles are required for support for the DPI Project as compared to qualitative research articles. Conduct a search in the GCU Library using the nursing databases for a primary quantitative article that provides support for your proposed intervention and briefly explain how the research provides evidence that the intervention would improve the problem at your practice site.
Topic 5
DQ 1
In your own words, describe personal and research bias and explain why bias is one of the main reasons for poor validity in research outcomes. How could a quality improvement project (DPI Project) be affected if the research used had bias? How would the site be affected? Using one of the primary research articles you selected for you PICOT-D, discuss potential bias that could have occurred and how this affects the research outcomes and ultimately the validity of the studies. Is it still viable research for your DPI Project?
DQ 2
Explain the difference between statistical significance and clinical significance. Provide an example for each. How do statistical significance and clinical significance apply to a quality improvement initiative, like your future DPI Project?
Topic 6
DQ 1
Review the “Literature Evaluation Table.”
Explain how the criteria on this table helps you evaluate the quality of a primary quantitative research article to determine if it will support a practice improvement project (DPI Project). Which criterion is most helpful in identifying a qualifying research article and why? How does the “Levels of Evidence in Research” chart support your search and the use of this table?
DQ 2
Topic 7
DQ 1
A personal worldview is based on the personal philosophy (beliefs, concepts, or ideas about the world) that one creates, ether consciously or unconsciously. These influence how one sees and interacts with the world. Reflect on the principles that have created your worldview. Were these principles developed consciously or unconsciously? Do they help or hinder? What are the main principles you use?
Based on your self-reflection, discuss two core principles from your personal philosophy and explain how they have shaped your worldview. How do these impact your ability to think critically? How does “open-mindedness” influence nursing care when caring for patients who do not share your personal philosophy or worldview? How do you think others experience you based on the actions or attitude derived from your personal philosophy/worldview? (This response does not require research support.)?
DQ 2
Discuss two principles your personal worldview has in common with GCU’s Christian worldview. Explain how these common principles align with the mission and vision from your practice site and how they fundamentally serve to promote patient care. (This response does not require research support.)
Topic 8
DQ 1
Reflect on your different experiences in this course, from learning new tools to having to think critically to learning how to accept feedback. Discuss which aspects were most challenging and most rewarding. Based on your experience, what doctoral strategies helped you navigate these new experiences successfully (or could help you in the future)? How could you use these strategies as a leader at a local level or within the broader health care system to advocate for change?
DQ 2
Sometimes topic ideas for a PICOT-D/DPI Project are intriguing, but not completely feasible for one reason or another. Based on the instructor feedback you have received, explain why you have, or do not have, a feasible topic for your PICOT-D. What changes will you need to make in order to have a feasible topic for your PICOT-D? If it is not feasible, what other topics are you considering?
RESOURCES
Academic Writer Tutorial: Basics of Seventh Edition APA Style
View the “Academic Writer Tutorial: Basics of Seventh Edition APA Style” tutorial, located on the American Psychological Association (APA) website. You will use this resource throughout the course for assignments and discussions.
https://extras.apa.org/apastyle/basics-7e/?_ga=2.128488908.1153078724.1596866222-1012012210.1596866222#/
Doctor of Nursing Practice
Utilize the resources on the “Doctor of Nursing Practice” page, located on the GCU Library, to assist in completing your assignments. https://libguides.gcu.edu/DNP
The Essentials of Doctoral Education for Advanced Nursing Practice
Familiarize yourself with the following resource. The essentials discussed in it will be reviewed periodically throughout your DNP program.
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. http://www.aacnnursing.org/DNP/DNP-Essentials
DNP Institutional Review Board (IRB) Project Assessment Tool
Review the “DNP Institutional Review Board (IRB) Project Assessment Tool,” located in the DC Network.
You will use this resource to guide the focus of your Direct Practice Improvement (DPI) Project. The focus of the DPI Project in the GCU DNP Program is the application of strong evidence-based research to improve population/patient outcomes. As such, learners are highly encouraged to select a project topic that is anchored in either quality improvement (QI). This focus will result in the most actionable outcomes (i.e., “real-time” results). Learners need to be cautious of the scope and target population for their project or it may result in unforeseen delays in IRB
Learner Dissertation Page
All DNP learners are required to set up their own Learner Dissertation Page (LDP) housed in the DC Network. Throughout the program, learners will upload all completed assignments (including all practicum and practice immersion materials/assignments/hours) to their LDP to ensure availability for future use. This responsibility is in addition to the requirement of submitting assignments to dropbox in the LMS. This space will allow learners and the DPI committee, including faculty members, chair (assigned in DNP-955A), and the mentor/content expert, to communicate regarding the DPI Project privately. Learners are required to keep the following in their LDP under the “Portfolio” fol
The Doctor of Nursing Practice: Current Issues and Clarifying Recommendations
Read:
American Association of Colleges of Nursing. (2015). Doctor of nursing practice: Current issues and clarifying recommendations.
This document will be reviewed periodically throughout the DNP Program.
https://www.pncb.org/sites/default/files/2017-02/AACN_DNP_Recommendations.pdf
DNP Direct Practice Improvement Project Recommendations
Introduction
Online classroom discussion is a vital learning activity that enhances writing, critical thinking, and scholarly development. These skills establish the foundation for self-reflection and unbiased consideration of other perspectives that enhances the long-term development of the doctoral learner.
Successful doctoral learners engage faculty and colleagues in substantive conversations by reflecting on others’ perspectives while articulating their own views. More importantly, doctoral learners demonstrate the disposition to critically and reflectively consider new information, facts, and perspectives in the enhancement of their own knowledge and de
Doctor of Nursing Orientation Webinar
Attend the live “Doctor of Nursing Webinar.” Information on the webinar, and the registration link, are located in the DC Network under the DNP Calendar.
Doctor of Nursing Practice – Doctoral Community Getting Started Guide
Read the “Doctor of Nursing Practice – Doctoral Community Getting Started Guide,” located in the DNP PI Workspace section of the DC Network.
This resource includes essential information about developing your online presence in the program.
Optional: Grammarly
For additional information, the following is recommended:
Grammarly is an online writing assistance app that reviews written submissions and suggests context-specific corrections for grammar, spelling, word usage, wordiness, style, punctuation, and plagiarism. The reasoning for each suggested correction is provided, allowing users to make informed decisions about how to correct writing issues.
Grammarly can be installed as free browser extension, but Grammarly Premium requires an annual subscription. This subscription is not a GCU-required purchase, but it is strongly recommended to DNP learners.
https://www.grammarly.com/premium
The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing
Zaccagnini, M. E., & Pechacek, J. M. (2021). The doctor of nursing practice essentials: A new model for advanced practice nursing (4th ed.). Jones and Bartlett Learning. ISBN-13: 97811284079708
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Following the recent
ruling that pre-exposure prophylaxis (PrEP) can be prescribed for the
prevention of HIV within the National Health Service, what potential impact
might this have for individuals, health care and society?
Introduction
Pre-exposure
prophylaxis (PrEP) is medication taken by individuals without a diagnosis of
HIV, in order to reduce the risk of contracting the virus (Spinner et al.,
2016). The regimen of PrEP is typically composed of antiretrovirals in a
combined pill, typically tenofovir disoproxil fumarate and emtricitabine
(Brydon, 2018). In HIV-infected individuals, these antiretrovirals serve to
treat the infection, reducing the viral load of the patient; lifelong therapy
is needed with antiretrovirals to prevent clinical disease (i.e. AIDS) (Kelen
and Cresswell, 2017). In HIV-negative individuals the purpose of PrEP is not to
prevent viral transmission or entry into the body, but to reduce viral
replication to a level whereby the immune system can eradicate infected cells,
preventing established HIV infection (Brydon, 2018).
The evidence base
supporting the use of PrEP is substantial, indicating a reduction in HIV
transmission, particularly in men who have sex with men (MSM), a key target
population (e.g. Volk et al., 2015; LeVasseur et al., 2018). Therefore, PrEP
can be considered an effective preventative approach, along with other
strategies to prevent HIV infection, such as condom use (barriers methods) and
male circumcision (Dolling et al., 2014). This has led to the approval of PrEP
for the prevention of HIV within the National Health Service (NHS) within the
last year, building on the availability of PrEP in Scotland (Nandwani, 2017).
The remainder of this paper will consider the potential impact of this approval
process, focusing on individual, health care, and societal outcomes.
Individuals
The changes in availability and use of PrEP can have massive
effects on the individual. Firstly, NHS funding of PrEP can increase access to
the drugs and affordability of these drugs (Nichols and Meyer-Rath, 2017). PrEP
was only available through third parties and pharmacies from other nations,
increasing the cost of this preventative strategy and the risk of unreliable
sourcing from online companies (Brydon, 2018). Affordability and access are
particularly important in vulnerable groups and socioeconomically disadvantaged
members of the population, who may be at a higher risk of HIV infection
(Spinner et al., 2016).
One of the main individual benefits of the availability of PrEP
is the expansion of options available for those who are at-risk of HIV. Current
preventative strategies can have significant limitations, which limit their
practical application (Frankis et al., 2016). For instance, condom use requires
access to condoms and positive attitudes to their use, which are not always
present due to perceptions of diminished sexual pleasure (Dolling et all.,
2014). In these individuals, PrEP can provide an alternative to condom use and
ultimately empowers individuals to manage health risk (Frankis et al., 2016).
Other factors that interfere with traditional HIV prevention
practices, including religious beliefs, cultural factors and personal attitudes
to condom use, may lead to an acceptance of PrEP, increasing the power of the
individual to prevent HIV transmission (Stewart, 2016). Providing increased
opportunities and options for individuals to prevent HIV transmission is vital
in promoting heathier sexual behaviours, while increasing individual autonomy
and self-efficacy (Harawa et al., 2017). Therefore, the impact of PrEP approval
within the NHS may benefit those at greatest risk, while broadening access and
availability of preventative measures.
It is important to note that PrEP use does not protect against
sexually transmitted infections (STIs) and that the role of condoms in
preventing both HIV and STIs remains important and should be communicated to
individuals interested in PrEP (Storholm et al., 2017). Furthermore, individual
benefits are only possible if adherence to PrEP is likely to be optimal;
non-adherence reduces the effectiveness of the drug combination and can
increase risk of HIV transmission (Storholm et al., 2017). Therefore, selection
of the target population and individual education on PrEP use will be essential
in ensuring benefits. At present, 10,000 people are enrolled onto the PrEP
IMPACT evaluation in England and the results of this trial will provide
valuable insights into the individual benefits of the use of PrEP (NHS England,
2018).
Health care
From a health care perspective, the funding of PrEP by the NHS
can be considered beneficial in a number of ways. Principally, PrEP has been
shown to have a significant impact on HIV transmission rates in trials and ‘real-world’
evaluations, which may translate into a reduced HIV burden in the population
(Fonner et al., 2016; McCormack et al., 2016; Sagaon-Teyssier et al., 2016).
HIV infection is still associated with significant morbidity and mortality in
the population and therefore prevention can have significant benefits in how
health services manage population health (Hankins et al., 2015).
Furthermore, one of the most important impacts of PrEP use in
MSM from a health service perspective is the potential for cost savings in the
short and/or long term due to reduced rates of HIV infection. A
cost-effectiveness and modelling analysis has shown that PrEP in MSM is
associated with cost savings, based on an initial rollout of 4000 men within
the first year (Cambiano et al., 2018). Similar analyses have been performed
and are associated with cost savings with PrEP use, depending on the length of
time the projections are designed, the use of condoms within the target
population, the rate of STIs in the target population and the cost of
antiretroviral drugs (Drabo et al., 2016; Cambiano et al., 2018; Fu et al.,
2018).
Possible negative effects of PrEP have been considered in the
literature, with a predominant focus on an anticipated decline in condom use,
rise in STIs and the costs associated with these conditions (Kelen and
Cresswell, 2017). Although the relationship between condom use and PrEP use is
complex, there is no clear evidence that PrEP reduces condom use during sex,
although up to 30% of HIV-negative men with HIV-positive partners suggested
that they may be less likely to use condoms if PrEP were available in one study
(Hoff et al., 2015). However, in the context of committed couples, this may not
translate to an increased risk of STIs, although the risk of HIV transmission
needs to be considered in individuals who are less likely to use condoms (Hoff
et al., 2015). Furthermore, the IPERGAY (Intervention Préventive de
l’Exposition aux Risques avec et pour les Gays) study found equal rates of STIs
in patients using PrEP and those not using PrEP to prevent HIV transmission,
suggesting that risk-taking may not be associated with PrEP use
(Sagayon-Teyssier et al., 2016).
The cost-effectiveness of PrEP use in the NHS will partly depend
on the potential for an increase in condomless sex and STIs, suggesting that
this possibility should be closely monitored to ensure cost savings and
population health (Cambiano et al., 2018). More data will be needed to assess
the health care impact of PrEP use, particularly as the target population
becomes more clearly defined and expansion of PrEP use in England occurs (NHS
England, 2018).
Society
Finally, on a societal level, there is an important need to
consider the wider ethical, social and cultural aspects of PrEP use and the
impact of PrEP. Indeed, views on HIV and HIV management are often highly
polarized in society and within the British media (Jaspal and Nerlich, 2017).
HIV is associated with a significant level of stigma and any strategies used to
combat infection rates and to reduce the risks of relationships between
HIV-negative and HIV-positive individuals may serve to reduce stigma to some
extent (Grace et al., 2018). The psychological toll of stigma should not be
underestimated and strategies that alleviate stigma can have significant
benefits for quality of life and wellbeing (Grace et al., 2018).
However, part of the polarized perception of HIV management in
society associates negative connotations with the use of PrEP. An argument
against PrEP use for the prevention of HIV in the general population is the
perception that the medication could be seen as an invitation to promiscuity or
condomless sex, with negative moral and health implications (Knight et al.,
2016; Brydon, 2018). Similar arguments are generally proposed for all advances
in sexual health services (e.g. oral contraception) but are not generally
supported by the research evidence (Calabrese et al., 2016).
Therefore, it is important to ensure that public awareness and
education of the role of PrEP and the massive potential benefits of the
approach are not obscured by misinformation or unfounded claims in the media
(Jaspal and Nerlich, 2017). Health care professionals are well-placed to inform
the public and address such sources of misinformation but need to be supported
by policy makers and national guidance (Calabrese et al., 2016; Desai et al.,
2016). However, wider societal attitudes and stigma associated with HIV needs
to be challenged through policy and law-making to ensure individuals at-risk of
HIV have access to PrEP (Serrant, 2016).
Conclusion
In summary, the use of PrEP for the prevention of HIV infections
in the UK is supported by the evidence base and has become an important aspect
of NHS-funded interventions for those at-risk of HIV infection. The potential
impact of PrEP can be seen on an individual, health care and society level,
with reductions in HIV infections, cost savings, and improved availability and
access to health services. The implementation of PrEP needs to be closely
monitored to ensure public awareness and education is facilitated to prevent
negative health behaviors and risks.
