Learners must maintain a reflective journal integrating self-reflection and inquiry demonstrated in the current Doctor of Nursing Practice (DNP) course. General Requirements: Use th

Student Name

Grand Canyon University

DNP: XXX

2

The following reflection essay is an attestation of the nurse scholar’s acquisition of the course objectives of Grand Canyon University’s (GCU) Doctor of Nursing Practice (DNP) program for DNP-XXX (Enter the Course #) and the competencies set forth by the American Association of Colleges of Nursing’s (AACN) Essentials of Doctoral Education for Advanced Nursing Practice (American Associations of Colleges of Nursing, 2019). From scientific underpinnings to project completion, the AACN Essentials provide the core competencies for all nurses seeking a Doctor of Nursing Practice Degree. Comment by Formatting Notes: PLEASE READ: General Instructions for the Reflective Entries Provide an introduction and prepare the reader for what this reflection paper is about. Make sure to use a scholarly approach and not use first person e.g. do not use me, I, you. The first section has no header or title. Please do not copy this word for word. This is an example of how you can begin your reflection introduction and prepare the reader for the content.

For this reflective journal, analyze your own professional practice/skills/responses to provide a reflective summary that describes how the experiences in this course have personally enabled the DNP student to approach, attempt, or attain these competencies in his or her current course. Provide an introduction paragraph for this reflective essay to organize the essay for the reader. Use a scholarly approach (i.e., third person) in writing the reflective journal. This assignment is designed to help you think deeply about your learning and how you have achieved the competencies established by the AACN Essentials. Share your approach to learning, the resources used, and the strategies explored to achieve your personal learning goals. For more information, see the example Reflective Essay in the Appendix. Comment by Formatting Notes: See the example in the Appendix

Submit your Reflective Journal in the course drop box, and upload to the Typhon Tracking System under the corresponding course section. Learners must submit this deliverable in Typhon and LoudCloud. Failure to submit in both locations can result in an Incomplete for the course.

Grand Canyon University’s DNP-XXX course prepared this DNP learner to do what? What have you discovered about your professional practice, personal strengths, and weaknesses that surfaced while taking the course, additional resources, and abilities that could have influenced more optimal learning outcomes?

Is there a structure to this Reflective Journal? This journal is an exploration of personal learning experiences as a doctoral learner pursuing life-long learning. Each week describe a situation or experience which can be reflected upon as important or worth writing about. Describe your approach, feelings, or thoughts about the situation or experience. Explain what you have observed in terms of the DNP Essentials and DNP course objectives. What did you expect, learn, or decide about the experience?

Go to the DC Network and look at the DNP Essentials located in the Reflection Journal Template Folder. Reflect on these essentials and discuss at least three domains that align your experience with what you learned in the course and support your claim on how you accomplished them. Comment by Formatting Notes: Of the eight competencys of DNP nursing education, which ones do you feel you accomplished in this course? Address at least three in your reflection. For each competency/domain, use the domain as the Levell 2 heading as in the example. Essential I: Scientific Underpinnings for Practice Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice Essential IV. Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care Essential V. Health Care Policy for Advocacy in Health Care Essential VI. Interprofessional Collaboration for Improving Patient and Population Health Outcomes Essential VII. Clinical Prevention and Population Health for Improving the Nation’s Health Essential VIII. Advanced Nursing Practice

Conclusion Comment by Formatting Notes: DO NOT COPY this is an example only, re-write your own conclusion 🙂

The purpose of this DNP-XXX Reflection was to provide exemplars of the methods used to fulfill GCU’s course objectives and achieve the competencies outlined in the AACN’s Essentials by this DNP student. The DNP learner used the weekly required readings and learning activities, supplemental readings, scholarly discussions, and project updates to solidify these competencies and outcomes. Ethical considerations, project implementation, leading collaborative teams using IT, researching the internet for a variety of resources, and creating a project PowerPoint presentation was integral to the achievement of learner competencies.

References

American Association of College of Nursing. (2012, January 3). The essentials of doctoral education for advanced nursing practice. Retrieved from American Association of College of Nursing: https://www.aacnnursing.org/About-AACN/Who-We-Are/Staff-Directory Appendix

© 2023. Grand Canyon University. All Rights Reserved.

MODULE 1

DQ 1

Assessment Description

With attention to Figure 7-1, “Basic Components of a Healthcare Delivery Service,” in Advanced Practice Nursing: Essential Knowledge for the Profession, consider the following discussion question. There are four basic functional components of a health care delivery system. Discuss two components which will impact the implementation of your project site.

SOLUTION

A healthcare delivery system is comprised of four fundamental elements: financing, delivery, access to treatment, and quality of care. Two elements of a healthcare delivery system that might affect the execution of my project site are the financing and quality of care aspects. The financing aspect relates to how healthcare services are paid for and covers resources such as insurance, federal programs, and out-of-pocket payments (DeNisco, 2019). This element may influence my project site's execution by restricting the resources and cash available for required equipment, supplies, and employees. Without appropriate financing, the project's execution might be slowed or fail.

The quality of care provided is another crucial component since it directly affects the results of treatment. Patient results may not be optimal if the treatment they get is subpar, which might negatively influence the execution of my project site. This element is especially significant since it has the potential to impact patient satisfaction, which is an essential component of the provision of healthcare (Stimpfel et al., 2019).

In conclusion, the financing and quality of care components play an essential role in developing a healthcare delivery system. These aspects need to be properly examined and controlled in order to guarantee the successful completion of the project.

References

DeNisco, S. M. (2019).  Advanced practice nursing (4th ed.). Jones & Bartlett Learning, LLC.

Assessment Description

An organizational chart is a diagram that visually conveys the internal structure of the health care organization. The chart details roles, responsibilities, and relationships between individuals. Describe how you will work across and between levels of the organization at your project to achieve the measurable patient outcome for your project. Describe any impact of bureaucracy that you anticipate. Explain how organizational influence and bureaucracy both impact patient quality and safety outcomes. What are two challenges or rewards to be gained?

SOLUTION

An organizational chart is crucial for understanding how a healthcare organization is structured. I will utilize this chart in my project to comprehend the interactions between people at various organizational levels. By doing this, I will be able to recognize important stakeholders, comprehend their roles and duties, and decide how I may collaborate across organizational levels to realize the project's measurable patient outcomes.

Bureaucracy can significantly affect a project's success since it may impede communication between various organizational levels and hold down decision-making (Vohnsen, 2017). To minimize this effect, I will make it a priority to have open lines of communication with relevant parties and to build relationships based on trust and cooperation with the goal of navigating any bureaucratic hurdles that may arise.

Organizational influence and bureaucracy both have a substantial effect on patient quality and safety outcomes. Strong organizational influence may lead to enhanced procedures and more resources, which in turn improves patient outcomes, whereas bureaucracy can slow down the execution of initiatives and cause delays and barriers.

Two obstacles that must be overcome to achieve measurable patient outcomes are navigating bureaucracy and getting the appropriate resources and support. On the contrary, two rewards are the satisfaction of having a positive influence on patients and the chance to learn and progress professionally through cooperation and teamwork. Both of these may be achieved by working with other people.

References

Vohnsen, N.H. (2017). “The absurdity of bureaucracy.” Available at: https://doi.org/10.7228/manchester/9781526101341.001.0001.

10 Strategic Points

Assessment Description

This is an exempt assignment, worth 0.00 points; however, it is a required submission that must be completed to pass the course.

If you have registered to complete the DNP Virtual Nurse Residency (VNR) in this course, submit your final 10 Strategic Points assignment. Learners who fail to submit their final 10 Strategic Points assignment cannot attend the VNR.

If you are not attending the VNR in this course, compete the attestation located in the topic Resources and submit to the dropbox.

Approved PICOT

Assessment Description

This is an exempt assignment, worth 0.00 points; however, it is a required submission that must be completed to pass the course.

If you have registered to complete the DNP Virtual Nurse Residency (VNR) in this course, submit your approved PICOT-D. Learners who fail to submit their approved PICOT-D cannot attend the VNR.

If you are not attending the VNR in this course, compete the attestation located in the topic Resources and submit to the dropbox.

Literature Evaluation Table

Assessment Description

This is an exempt assignment, worth 0.00 points; however, it is a required submission that must be completed to pass the course.

If you have registered to complete the DNP Virtual Nurse Residency (VNR) in this course, submit your final Literature Evaluation Table. Learners who fail to submit their Literature Evaluation Table cannot attend the VNR.

If you are not attending the VNR in this course, compete the attestation located in the topic Resources and submit to the dropbox.

Preconference Evaluation: Individual Success Plan (ISP)

Assessment Description

The Individual Success Plan (ISP) assignment in this course requires your collaboration with the course faculty early on to establish a plan for successful completion of mutually identified and agreed-upon specific deliverables for your programmatic requirements. Programmatic requirements are: (1) completion of required practice immersion hours, (2) completion of work associated with program competencies, and (3) work associated with completion of your Direct Practice Improvement (DPI) Project.

A preconference meeting is intended for the learner and preceptor/mentor to review course- and learner-specific learning objectives: the roles, responsibilities, and expectations of the learner and preceptor/mentor during this practice immersion experience. All faculty and preceptor/mentor information will be given to each party by the learner. Any course or program information requested by the preceptor/mentor will be provided by the learner. During this meeting, the learner and preceptor/mentor will discuss the course and practice immersion goals, including any projects that are to take place. The faculty will review the submitted document and must approve proposed projects at this time. The faculty will also send an introductory email to the preceptor/mentor.

General Requirements:

Use the following information to ensure successful completion of the assignment as it pertains to deliverables due in this course.

· Locate and download Individual Success Plan (ISP) and Direct Practice Improvement (DPI) timeline documents in the DNP PI Workspace.

· Review the DNP Program Milestones document in the DNP PI Workspace and identify which domains, competencies, and milestones apply to this course. Note: Not all courses have milestones.

· Determine what practice immersion experiences you plan to seek in order to address each competency. Include how many hours you plan to set aside to meet your goals. Learners will apply concepts from each of their core courses to reflect upon, critically examine, and improve current practice and are required to integrate scholarly readings to develop case reports that demonstrate increasingly complex and proficient practice.

· Use the ISP to develop a personal plan for completing your practice immersion hours and how competencies will be met. Show all of the major milestones and deliverables in the timeline.

· Within the ISP, ensure you identify specific deliverables which can include the following: individualized DNP practice immersion contracts; comprehensive log of practice immersion hours applied to doctoral-level learning outcomes; learner evaluations; preceptor/mentor evaluations; current and updated CV; scholarly activities; GCU DNP competency self-assessment; reflective journal; course goals and plan for how competencies and practice immersion hours will be met; faculty and preceptor/mentor approvals of course goals and documented practice immersion hours; and DPI Project milestones.

· A preconference and a postconference/evaluation between learners and preceptors/mentors are mandatory for all learners enrolled in all DNP courses (from DNP-805 and DNP-815A on). Conferences may be conducted face-to-face or via technology. A copy of the wet-ink or digitally (digital identifier) signed document must be uploaded into the digital classroom no later than the end of Topic 1.

· Overall course- and learner-specific objectives: These objectives should be discussed during each conference, as learners are responsible for completing all experiences as mandated for the program.

· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

· This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

· You are not required to submit this assignment to LopesWrite.

· Learners will submit this assignment using the assignment dropbox in the digital classroom. In addition, learners must upload this deliverable to the Learner Dissertation Page (LDP) in the DNP PI Workspace for later use.

Directions:

1. Identify the specific deliverables you will complete throughout this course from those defined above with your faculty. Update your faculty/chair with any revisions or changes to the ISP.

2. List the challenges you expect to encounter as you continue the practice immersion hour and competency requirements throughout this course. How might you overcome these challenges?

3. Complete the Contact Information table at the beginning of the ISP resource, and type in your signature (learner only) and the date on which you completed the table. Read the information in the ISP document, including the following: Learner Expectations, Derivation of the ISP, and Instructions for Completing the ISP.

4. Follow the instructions and complete the ISP.

Describe three factors that impact cost or revenue within your organization. How might these variables impact your DPI Project deliverables?

SOLUTION

All organizations calculate their profit margin, as the impacts of cost or revenue can have significant implications on the business. Understanding cost and revenue within the organization is one of the most essential indicators of knowing whether the organization is stable and its ability to remain in business or if there is a going concern. In most cases, what can easily affect an organization’s profit margin are its net profits, sales earnings, and merchandise costs (Beers & Anderson, 2022). However, in the healthcare field some of the most common variables influencing a healthcare organization's costs or income are competition, changes in regulations, and the volume of clients (DeNisco, 2019). Costs and profits may change depending on the degree of competition in the industry. When there is much competition, it might cause prices to drop, which in turn makes it harder to generate income. Organizational operations may also be significantly impacted by changes in applicable regulations. Changes in legislation or policy, for instance, might necessitate an adjustment of the organization's budget projections, which would affect both its costs and revenues (Sommers & Gruber, 2017). Lastly, the number of customers that a company serves may also affect the revenue that it generates. If the number of the organization's customers drops, the revenue generated by the company might potentially fall as a consequence.

The importance of variable cost structures in health or medical practices cannot be overemphasized because the cost of running a business in this field is very much different from the way other small businesses run. While it is not about building revenue alone, it is also about effective customer service and high-quality patient care. In addition, the healthcare industry is so complicated that as the model for reimbursement changes, so is efficient cost management becomes a key component of the survival and stability of the organization. Therefore, these factors may have an influence on the budget and timeframe of my DPI Project. For instance, intense competition may result in lower prices for products and services and make it challenging to generate revenue for the organization, which directly or indirectly impact services offered. On the other hand, a decline in customer volume may translate into decreased revenue for the organization. Similarly, regulatory or policy changes may influence the project's budget, scope, and timing, necessitating a modification in the project plan to accommodate these changes. In order to keep the project on track and reach its goals, it is crucial to keep an eye on these factors and make any required modifications to the budget and schedule.

References

DeNisco, S. (2019). Advanced Practice Nursing: Essential Knowledge for the Profession: Essential Knowledge for the Profession. 4th edn. Jones & Bartlett Learning.

Beers, B., & Anderson, S. (2022). Investopedia: Two Factors That Affect Profit Margins. Retrieved February 16, 2023 from https://www.investopedia.com/ask/answers/102714/what-are-some-examples-factors-will-affect-my-profit-margin.asp

Sommers, B. D., & Gruber, J. (2017). Federal funding insulated state budgets from increased spending related to Medicaid expansion. Health Affairs, 36(5), 938-944. https//doi.org/10.1377/hlthaff.2016.1666

DQ-2

Assessment Description

Post your PICOT and expand in detail on your selected patient population. Include any characteristics that impact the socioeconomic/sociopolitical factors. How will these factors influence patient outcomes and the financial viability of the organization in the community? How does this align or differ from norms of the U.S. health care system?

SOLUTION

My PICOT is awaiting approval. I recently changed my topic, hence, the delay. I had an initial topic that I was working on but was not approved because the PICOT team disapproved of two of my articles. The following is the new PICOT that I am currently working on.

PICOT: To investigate how socioeconomic and political issues affect patient outcomes and the financial viability of healthcare companies in low-income rural communities.

The demographic chosen for this study is Low-income people living in rural regions. Numerous obstacles prevent these people from obtaining high-quality treatment, including a lack of money, inadequate healthcare infrastructure, and a greater prevalence of chronic illnesses (Balcazar & George, 2018). Furthermore, these individuals are often members of ethnic and racial minority groups, are jobless or have low-paying occupations, and encounter language problems when seeking healthcare. These socioeconomic variables substantially influence their health outcomes, resulting in a greater prevalence of chronic illnesses and a shorter life expectancy.

The socioeconomic and sociopolitical issues significantly impact the financial viability of healthcare institutions in low-income rural regions and patient outcomes. Inadequate access to adequate healthcare services leads to a greater prevalence of chronic illnesses, poor health outcomes, and a shorter life expectancy (Balcazar & George, 2018). These factors also have an influence on the financial sustainability of community healthcare facilities, as they strive to deliver excellent treatment to a population with scarce resources.

This situation is different from the standards of the American healthcare system, which place an emphasis on providing all people with access to high-quality treatment, regardless of their financial status. To improve patient outcomes and guarantee the financial survival of healthcare facilities, it is crucial to address healthcare inequities and improve access to high-quality healthcare services (Sommers & Gruber, 2017).

References

Balcazar, H., M. S., & George, S. (2018). Community health workers: Bringing a new era of systems to change to stimulate investments in health care for vulnerable US populations. American Journal of Public Health, 108(6), 720-721. https//doi.org/10.2105/AJPH.2018.304427

Sommers, B. D., & Gruber, J. (2017). Federal funding insulated state budgets from increased spending related to Medicaid expansion. Health Affairs, 36(5), 938-944. https//doi.org/10.1377/hlthaff.2016.1666.