Nursing Problems in Research and QI/DNP Projects
Nursing problems in research studies typically identify gaps in knowledge (e.g., lack of evidence on best practices for preventing hospital-acquired pressure injuries). In contrast, QI and DNP projects address gaps in practice (e.g., inconsistent application of evidence-based protocols in a specific clinical setting).
Comparison of Problem Presentation:
| Aspect | Research Study | QI/DNP Project |
|---|---|---|
| Focus | Expands theoretical knowledge | Improves real-world application |
| Problem Definition | "What is the best intervention for X?" | "Why isn’t intervention X being used here?" |
| Outcome Influence | Informs future research & guidelines | Directly changes local practice |
Key Measurement/Variable in Each Study/Project
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Research Study: Incidence of hospital-acquired pressure injuries (HAPIs).
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QI Project: Compliance rate with turning protocols (e.g., % of patients turned every 2 hours).
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DNP Project: Reduction in HAPI rates post-implementation of a new protocol.
Critique of Hicks’ (2024) Question Development Tool
Hicks’ tool structures questions using PICO (T) (Population, Intervention, Comparison, Outcome, Time), ensuring alignment between problem, evidence-based practice (EBP) question, and measurement.
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Problem: Clearly defines knowledge (research) vs. practice (QI/DNP) gaps.
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EBP Question: Ensures feasibility (QI/DNP) or generalizability (research).
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Measurement: Must be quantifiable (e.g., compliance rates, HAPI incidence).
Strengths:
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Standardizes question formulation.
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Links problem to measurable outcomes.
Weaknesses:
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May oversimplify complex clinical issues.
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Requires refinement for local context in QI/DNP projects.
Conclusion
Research, QI, and DNP projects address different gaps but use structured frameworks (like PICO) to drive practice change. Effective measurement (e.g., compliance rates, HAPI incidence) ensures actionable outcomes. Hicks’ tool provides a useful scaffold but must be adapted to specific clinical needs.