POST 1

L. Thorpe

The doctoral prepared nurses are uniquely positioned for responsible leadership as essential members of the health care system. The professional responsibility contributes to research and clinical inquiry initiatives that advance health care delivery outcomes. Because of the rapidly changing environment of doctoral education, collaborative relationships between the Doctor of Nursing Practice and the Doctor of Philosophy-prepared nurses continue to evolve (Pencak-Murphy et al., 2015). The DNP nurse and Ph.D. nurse work in close collaboration. Both work with all the disciplines in achieving optimal patient outcomes. The doctorly prepared nurses assist others with their advanced skill and expertise in leading other health care professionals. Whether a nurse is an independent DNP practice nurse or a Ph.D. researcher, both collaborate to obtain data relevant in providing patient-centered care (Cowan, 2019). Inter-professional communication is essential for all disciplines, especially those with terminal degrees, in achieving the most from other interdisciplinary professionals. The strength and focus of both the DNP and the Ph.D. nurses serve as important unified components in quality improvement, evidence-based practice, and research (Hooshmand et al., 2019). 

Communication at every level is essential. Healthcare professionals collaborate to optimize patient care from all different healthcare backgrounds. For example, the informatics professional. The work of the DNP and Ph.D. professionals optimizes new system developments. This results in collaborating with nurses, physicians, social workers, healthcare lawyers, administration specialists, physical therapists, and other disciplines in transforming patient care. The nursing point of view is relevant as having an understanding of all care professional’s opinion is crucial (Falkenberg-Olson, 2019). The DNP nurse understands these particulars and works across-the-board in acknowledging all intricacies. Understanding other healthcare professionals’ perspectives are critical as one may not always grasp the big picture from an advanced approach. Often many disciplines do not understand current terms and definitions, which often leads to a lack of comprehension. This can often be corrected with education sections and explanations.

Building collaborative partnerships between DNP and Ph.D. nurses benefits the health care system and patients. Leadership can help foster partnerships that are sustainable through successful collaborative projects (Falkenberg-Olson, 2019). There is a growing emphasis on intra and interprofessional efforts within the health care arena that provides opportunities for shared resources between the DNP and the Ph.D. nurse collaboration (Hooshmand et al., 2019). The advanced practice role offered doctoral prepared nurses to work tirelessly in implementing policies and create advocacy initiatives to transform health care systems. The doctoral-prepared nurses must understand each other’s background and focus on what each can contribute to translating research into practice (Cowan, 2019).

References

Cowan, L. P. (2019). A model of successful DNP and PhD collaboration. Journal of the American Association of Nurse Practitioners, 31(2), 116-123. https://doi.org/10.109 7/JXX.0000000000000105

Falkenberg-Olson, A. C. (2019). Research translation and the evolving PhD and DNP practice roles: A collaborative call for nurse practitioners. Journal of the American Association of Nurse Practitioners, 31, 447-453. https://doi.org/10.1097/JXX.0 000000000000266

Hooshmand, M., Foronda, C., Snowden, K., de Tantillo, L., & Williams, J. R. (2019). Transforming health care through meaningful Doctor of Nursing practice community partnerships. Nurse Educator, 44(3), 132-136. https://doi.org/10.1097/NNE.000000000 000057

Pencak-Murphy, M., Staffileno, B. A., & Carlson, E. (2015). Collaboration among DNP and PhD prepared nurses: Opportunity to drive positive change. Journal of Professional Nursing, 31, 388-394. https://doi.org/10.1016/j.profnurs.2015.03.001

POST 2

P. Medeiros

Value of Intra- and Interprofessional Collaborative Practice as a DNP

            The doctoral prepared nurse has been described to hold a degree that “builds upon the advanced nursing practice specialization and provides additional preparation in the formulation, interpretation, and utilization of evidence-based practices, health policy, information technology, and leadership” (Waxman & Maxworthy, 2010). Essentially, the DNP graduate would be able to accommodate the colossal voids in both the academia and practice settings. A nurse with a doctorate, would have the ability to serve at the same level as other professions, collaborate effectively with other professions, and have their opinions and skills better recognized (Laurette Education, 2011d). 

            Intrapersonal communication is the principal base of interpersonal communication. Primarily since it is our experience on which our perception ultimately relies on, and subsequently our perception that influences our integration with other individuals. In other words, intrapersonal communication is categorized as being individual; for example, as in always kept within a person’s mind. (Zaccagnini & White, 2017). Whereas, interpersonal is classified as relational, such as information flows from one person to another (Zaccagnini & White, 2017). Furthermore, intrapersonal communication is relied heavily on the purpose of self-expression of one’s thoughts and opinions. On the contrary, interpersonal communication requires either verbal or non-verbal means to communicate their thoughts. 

Examples of Intra- and Interpersonal Collaborative Practice

            The best way to describe the impacts of intra- and interprofessional collaborative practice on my present role as an advanced practitioner would be during multidisciplinary rounds. Each morning in the intensive care unit, the physician, advanced practice practitioner, bedside nurse, dietary, case management, pharmacy, and therapy services round on each patient. We utilize a collaborative approach by expressing our opinions and thoughts on ways to improve the patient’s overall outcome with implementing evidenced-base practices. It is a great opportunity to address the needs of the patient and come together as a group to make decisions that ultimately would serve in the patient’s best interest. I find that multidisciplinary rounds essentially allow for the opportunity to tie up all loose ends, resulting in the delivery of optimal patient care.

            Subsequent, communication at every level is thought as being essential. In 2001, the Institute of Medicine Committee on Quality of Healthcare in America suggested that healthcare professionals to work in interprofessional teams, to allow for optimized communication and address widely complex health care needs and challenges (Bridges, Davidson & Odegard & et al., 2011). Finally, attending organizational conferences to further advance knowledge on the latest up to date practice guidelines would also be a form of interprofessional communication. 

References

Bridges, D., Davidson, R. & Odegard, P. et. al. (2011). Interprofessional Collaboration: Three

            Best Practice Models of Interprofessional Education. Medical Education Online.

Laureate education (Producer). (2011d). The Professional Role of the DNP-Prepared Nurse

. Retrieved from https://class.waldenu.edu

Waxman, K.T., & Maxworthy, J. (2010). The Doctor of Nursing Practice Degree and the Nurse 

Executive: The Perfect Combination. Nurse Leader (8)2, 31-33. Retrieved from 

https://doi.org/10.1016/j.mnl.2010.01.011

Zaccagnini, M.E., & White, K.W. (2017). The Doctor of Nursing practice essentials: A new model for advanced practice nursing (3rd ed.). Sudbury, MA: Jones & Bartlett

POST 3 

A. Laura

Identify the concept and the related practice problem

A concept is defined as a term that abstractly describes and names an object, phenomenon, or an idea thus providing  it with a distinct identity or meaning (Gray, Grove, & Sutherland, 2017)). The concept that I have identified that is related to a problem in the nursing practice is incivility and bullying. Incivility and bullying has been shown an increase in medication errors, increase turnover rate, depression in staff, and suicide. The main premise of the concept is that most health care workers do not understand the concept of incivility and bullying. 

A summary of your concept analysis (sharing your clarified concept) and the related research topic

According to Walker & Avant (2011), the steps in concept analysis includes selecting a concept, determining the aim of the analysis, identify all the uses of the concept, determine the defining attributes, identifying the model case, identifying borderline, related, contrary, invented, and illegitimate cases, identify antecedent and consequences, and defining empirical referents. The aforementioned concept is abstract in nature, the more abstract a concepts becomes, empirical indicators become less concrete and less directly measurable. The aim of the analysis would include identifying bullying and uncivil behaviors among health care workers. Incivility could be caused by low-self esteem from the aggressor, unanswered  psychological issues, or antecedent events in their life such as abuse and or bullying directed towards the aggressor. Empirical referents could include fear of rejection and lack of emotional intelligence. 

Describe the importance of this concept and research topic to nursing practice 

This concept and research topic is more important now than ever. With the emotional toll  that the crisis  has taken on health care workers during this pandemic, further research would be beneficial in handling the day to day  acts of incivility and bullying that may be enhanced by a heightened since anxiety, fear, and uncertainty that has been caused by the COVID 19 pandemic. 

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.) St. Louis, MO: Saunders Elsevier  

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Philadelphia, PA: Wolters Kluwer

Walker, L.O. & Avant, K.C. (2011). Strategies for theory construction in nursing (5th ed.).Upper Saddle River, NJ: Prentice-Hall

POST 4

S. Gambill

Concept analysis is an essential component of research processes and influences theory development.  According to McEwin and Wills (2014), concepts are symbolic terms that signify a phenomena that ensues in nature or in thought (p. 50).  More specifically, individuals can delineate concepts relative to their phenomena and outline a pattern of usage as a foundation of theory and knowledge development to enhance practice (Coughlan, Cronin, & Ryan, 2010, p. 64).  With this being said, the correlation between research, theory, and clinical practice is enabled through concept analysis which impacts nursing care.  While concept analysis is critical to disciplines, concept invention is also pivotal.  Concept inventing consists of innovative conceptualization and interpretation of concepts that are distinctly different from other analysis and concepts that dominate a discipline (Parse, 2006, p. 289).  Concepts not only guide disciplines, but individual decision-making and perceptions are impacted.  

According to Penrod (2007), concept analysis is analytical method that is comprised of four philosophical and science-oriented principles: epistemological, pragmatical, linguistical, and logical (p. 659).  With this being said, there is no shortage of concepts relevant to the nursing discipline, especially in the perioperative setting.  A practice problem in the perioperative setting that I have opted to address is the lack of optimal psychosocial and spiritual care that is being rendered to patients, especially due to the implications that the COVID-19 pandemic has had on approaches to care.  The concept that is applicable to this practice problem is the concept of comfort.  

Concept analysis is complete by defining, differentiating, delineating antecedents, delineating consequences, modeling, analogizing, and synthesizing (McEwen & Wills, 2014, p. 65).  The concept of comfort is defined as a “holistic experience, a stated of satisfying human needs for ease, relief, and transcendence in physical, psychological, social, and spiritual contexts” (Caldeira, Martins, Pinto, & Rodgers, 2017, p. 244).  Especially in nursing, comfort is a term that varies based on scenario, context, and individual perception.  In the perioperative setting, comfort commonly refers to environmental contentment, pain relief, and psychological or emotional well-being.  Differentiating concepts and other similar concepts include caring, quality of life, holistic care, spirituality, or happiness (Caldeira, Martins, Pinto, & Rodgers, 2017, p. 244).  More specifically, comfort has been characterized similarly to pain relief, palliative measures, supportive care, well-being, and cosiness (Caldeira, Martins, Pinto, & Rodgers, 2017, p. 244).  Antecedents include discomfort, distress, and suffering (Caldeira, Martins, Pinto, & Rodgers, 2017, p. 244).  As outlined, it is anticipated that comfort is perceived or occurs when implementing caring in nursing.  This is proven true by facilitating pain relief, implementing palliative and supportive measures, and enabling well-being or wellness.  Ultimately, comfort is associated with quality patient experiences and optimal well-being.  In the perioperative setting, comfort is frequently impacted by environmental factors including ambient air temperature and lighting, high-traffic settings with overstimulating quantities of professionals from the multidisciplinary team, time restraints or procedure delays due to explicit factors, and anxiety relative to their condition or procedure, to name a few.  Comfort is often facilitated by establishing rapport, diminishing excessive stimulation, providing measures to induce a peaceful and ambiently accommodating environment, acknowledging emotional concerns, and addressing patient needs.

Due to policy and practice changes that have transpired since the COVID-19 pandemic began to overwhelm community health, comfort in the perioperative setting has been hindered.  Changes in visitor policies, COVID testing, environmental stimulation due to increase sanitization, diminished interpersonal communication due to personal protective equipment, and the alteration of the implementation of spiritual services has altered the achievement of comfort.  While public health and preventing the communication of such a devastating virus is critical, the inability to achieve optimal comfort in patients impacts their care experience and outcomes.  Are the policies and procedure that are implemented for public health purposes relevant to COVID-19 diminishing the deliverance of comfort care and patient comfort and negatively impacting patient outcomes in the perioperative setting?  I have perceived diminished comfort in terms physical, psychological, social, and spiritual well-being in the perioperative setting.  An appropriate research topic is “The Implications of COVID-19 Policies On Patient Comfort in the Perioperative Setting: A Review of Patient Satisfaction and Outcomes.”  It is evident that this concept and research topic are important to nursing practice.  

References

Caldeira, S., Martins, J. C., Pinto, S., & Rodgers, B. (2017). Evolutionary analysis of the concept of comfort. Holistic Nursing Practice, 31(4), 243-252. doi:10.1097/HNP.0000000000000217. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edo&AN=123918983&site=eds-live&scope=site

Coughlan, M., Cronin, P., & Ryan, F. (2010). Concept analysis in healthcare research. International Journal of Therapy & Rehabilitation, 17(2), 62-68. doi:10.12968/ijtr.2010.17.2.46331. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=t            rue&db=rzh&AN=105306662&site=ehost-live&scope=site

McEwin, M., & Wills, E. M. (2014). Theoretical basis for nursing. (4th ed.) Philadelphia, PA: Wolters Kluwer Health.

Parse, R. R. (2006). Concept inventing: Continuing clarification. Nursing Science Quarterly,19(4), 289. doi:10.1177/0894318406292785. Retrieved from https://journals-sagepub-com.ezp.waldenulibrary.org/doi/pdf/

Penrod, J. (2007). Living with uncertainty: Concept advancement. Journal of Advanced Nursing, 57(6), 658-667. Retrieved from https://onlinelibrary-wiley- com.ezp.waldenulibrary.org/doi/epdf/10.1111/j.1365-2648.2006.04008.x

EXAMPLE OF HOW EACH REPLY COMMENTS NEEDS TO LOOK.

The relationship between the DNP and Ph.D. prepared nurses have evolved from competition to collaboration (Cygan & Reed, 2019). Collaboration between the doctorly-prepared nurses has led to enriched opportunities for nurses. The DNP and Ph.D. nurses are innovating research, education, and practice. Both roles require extensive education and training in critically evaluating literature that best contribute to nursing with the goal of continually improving nursing science and nursing practice (Cowan, 2019). The addition of the DNP and Ph.D. professionals in healthcare organizations offers an opportunity to raise healthcare leadership expectations. Effective intra and inter-professional collaborations can transcend the profession leading to the creation of need research and evidence. Falkenberg-Olson (2019) contended the DNP and Ph.D. 

References

Cygan, H. R., & Reed, M. (2019). DNP and PhD scholarship: Making the case for collaboration. Journal of Professional Nursing, 35, 353-357. https://doi.org/10.1016/j.p rofnurs.2019.03.002

Cowan, L. P. (2019). A model of successful DNP and PhD collaboration. Journal of the American Association of Nurse Practitioners, 31(2), 116-123. https://doi.org/10.109 7/JXX.0000000000000105