NURS-FPX 9100 Defining the Nursing Doctoral Project Virtual Check-in 2 Challenges and Revisions made on Part I of the Project Charter

Part 1 of the charter was an excellent opportunity to address the gap analysis, develop the PCOT question, and specify the project aim. I appreciate guidance provided by my instructor and preceptor. Feedback provided guided me to clarify the relevance of the project and modifications necessary to achieve the intended outcomes. However, there were several revisions made on part I of the project charter to address the issue and enable Optum to make significant progress towards improving the quality and safety of patient care. One revision was the need for a clear PICOT question focused on measuring compliance with CHF protocol. The instructor clarified the need to focus on compliance. Thus, I had to adjust the PICOT question to capture the emphasis on measuring advanced practice nurses’ compliance with CHF protocol.

The professor also raised concerns about Optum’s willingness to share data on compliance measures. I engaged the preceptor who clarified the organization’s willingness to provide relevant information that would facilitate completion of the project in line with the anticipated outcomes. Another revision was in response to the instructor’s emphasis on outlining steps of the guidelines and the level of compliance for the selected patients. I engaged the preceptor, who provided insights into the audited charts, which showed the level of compliance with heart failure management practices. The preceptor guided me to understand the nursing team’s awareness of disease trajectory and recommendations available to optimize care outcomes. The modifications allowed me to stay visualize outcomes and transition successfully to part II and III of the project charter.

Progress on Part II and III of the Project Charter

Successful completion of part I of the charter enhanced confidence in completing subsequent sections. I made significant progress in identifying stakeholders, the team leader and appropriate leadership styles, and the communication plan that matches project aim. However, a major issue arising is the busy schedule of some stakeholders and team members such as the advanced care nurse and nurse manager. Complex events in palliative care mean that the members may spend more time responding to patients’ demand, which limits the time available to participate in this project (Riahi & Khajehei, 2019). However, I am glad that my preceptor emphasized commitment to helping me complete the project by providing advice and other relevant information whenever other team members become unreachable due to work commitments. With the PDSA framework, completing part II and III becomes more manageable due to systematic and forward-thinking nature of the framework (Knudsen et al., 2019). I also had an interesting time developing the SWOT analysis. Capturing the strengths, weaknesses, opportunities, and threats reinforced ability to ascertain the impact of the project on quality and safety of patient care. The framework guided me to clarify the resources available and limitations that may undermine success of the project.

General Discussions about the Project and Progress

The project is an excellent opportunity to make meaningful contributions towards helping Optum achieve strategic goals. Weekly chart reviews of compliance with treatment guidelines will determine the relevance of the project in optimizing care outcomes. By the end of the 10 weeks, I am optimistic that nurse practitioners and physician assistants working in a complex care setting will acquire the knowledge and skills necessary to comply with protocols for CHF patients. I hope that my project contributes immensely to strengthening staff commitment to using evidence-based protocols to manage patients vulnerable to heart failure.

References

Knudsen, S. V., Laursen, H.V., Johnson, S., Bartels, P.D., Ehlers, L. H., & Mainz, J. (2019). Can quality improvement improve the quality of care? A systematic review of reported effects and methodological rigor in plan-do-study-act projects. BMC Health Services Research,19(683), 1-9. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4482-6

Riahi, S., & Khajehei, M. (2019). Palliative care: A systematic review of evidence-based interventions. Critical Care Nursing Quarterly, 42(3), 315-328. https://www.researchgate.net/publication/333375860_Palliative_Care_A_Systematic_Review_of_Evidence-Based_Interventions