Evidence-based practice (EBP), quality improvement (QI), and clinical nursing research employ systematic inquiry and disciplined methods to address clinical problems and health care disparities. Evidence-based practice in nursing involves clinical decision-making based on the integration of the best available evidence, nursing theory, clinical expertise and judgment, and patient preferences and values (Zimmerman, 2017); QI involves changing or enhancing existing practice or processes within specific organizations or patient groups; and clinical nursing research involves the generation of credible evidence to inform nursing practice and expand the nursing knowledge base (Polit & Beck, 2017). These strategies enable the delivery of safe, high quality, cost-effective health care to optimize the health and health care outcomes of individuals and populations. Therefore, it is incumbent upon faculty to ensure that the College MSN graduates are proficient in the knowledge and skills upon which evidence-based health care and improvement efforts are built. 

Purpose: The MSN-614 Health Care Improvement Project (HCIP) prepares the College DEMSN students to engage in the scholarship of clinical practice using EBP, QI, and/or clinical nursing research methodology. 

Description: The HCIP constitutes a criterion-referenced assessment of student performance and as such, students’ successful completion of MSN-614 is dependent upon the successful performance of all essential elements of the project. The HCIP yields three complementary products: 

  1. HCIP Final Paper – consisting of Part and Part 2 of the paper 
  2. HCIP Presentation 
  3. HCIP Self Assessment

Over the course of the project, all College DEMSN students:

  • select and justify a focus of inquiry (i.e., health problem of interest); 
  • conduct a systematic review of the literature involving the search of multiple electronic databases, appraisal of scholarly literature, and synthesis of research findings; 
  • formulate recommendations for clinical practice and future research based on current and credible evidence; 
  • engage in the iterative process of scholarly writing;
  • disseminate findings of their HCIP in a scholarly presentation; and 
  • engage in meaningful peer feedback, and self assessment, including self-reflection.

It is anticipated that most students will choose to use EBP methodology to fulfill the HCIP requirements; however, with the explicit permission of faculty, students may alternatively develop a QI Project Proposal or Clinical Nursing Research Proposal to demonstrate the achievement of expected HCIP outcomes. QI and clinical nursing research proposals include all major elements of the EBP HCIP as described in this document and more. Additional requirements for QI project proposals are described in the Institute for Healthcare Improvement’s Fundamentals of Health Care Improvement: A Guide to Improving Your Patients’ Care (Orgrinc et al., 2012). Additional requirements for clinical research proposals include a description of the proposed study method (sample, setting, instruments, subject recruitment and data collection and management procedures, and data analysis), human subjects research protections, and a study timeline and budget as prescribed by faculty. Consequently, QI project and clinical nursing research proposals involve additional student performance criteria, which are determined by faculty on a case-by-case basis. 

Learning Opportunities: In addition to assigned readings, interactive instruction, and small group work, student learning in MSN 614 is supported through writing assignments intended to promote successful completion of the HCIP as well as the course. These learning opportunities include but are not limited to the following:

  • HCIP Health Problem of Interest and PICO(t) Question Form: Identification of a population and health problem of interest, definition of that problem, and initial formulation of the HCIP PICO(t) question. 
  • HCIP Planning Form: Clarification of the population and health problem of interest, documented evidence of the relevance of the health problem abstracted from the literature [data/statistics], initial list of advanced nursing practice strategies currently used to address the problem, and as necessary, revision of the initial the HCIP PICO(t) question. 
  • HCIP Peer Review: Each student will give feedback, as if they were the faculty, to a peer. This exercise will assist in giving feedback and appreciate how others write. 
  • HCIP Paper Part 1 Draft: Initial submission and revisions for the final paper, in response to formative feedback. 
  • HCIP Paper Part 2 Draft: Initial submission and revisions for the final paper, in response to formative feedback.

Scholarly writing is an iterative process; therefore, students should anticipate that multiple revisions of any given section of the HCIP paper may be required to demonstrate effective graduate-level writing. 

HCIP Learning Objectives Linked to MSN-614 Course Outcomes

The DEMSN student will:

  1. Clearly present a health problem (phenomenon of interest), effectively arguing for the importance of exploring it (Course outcomes: 3, 5, and 6). Must be focused in the United States and have a Nursing aspect. 
  2. Generate a researchable question, consistent with a selected method of inquiry (Course outcomes: 1, 3, 5, and 6).
  3. Precisely apply disciplinary frameworks in the scholarship of advanced nursing practice (Course outcomes: 1-6).
  4. Skillfully employ technology in the pursuit and communication of scientific knowledge (Course outcomes: 1, 5, and 6).                                         
  5. Determine the state of the science relative to selected advanced nursing practice interventions aimed at addressing the phenomenon of interest (Course outcomes: 1-6).
  6. Formulate preliminary but relevant evidence-based recommendations for advanced nursing practice and future research, identifying essential resources for and potential barriers to the implementation of those recommendations (Course outcomes: 3-6). 
  7. Effectively disseminate the key elements of a focused inquiry through scholarly writing and oral presentation (Course outcomes: 3, 2, and 6).

Demonstrate awareness of self and how personal strengths and limitations will inform one’s ongoing pursuit of scientific knowledge and future delivery of ethical, evidence-based advanced nursing care 

(Course outcomes: 4