Innovations to Improve the DNP Practice Environment: An Evaluation of the DNP Project Process

Abstract Purpose: This project aims to identify the gaps in DNP education and project development, implementation, and dissemination. The DNP Project will also recommend new and innovative approaches that produce graduates with the capacity to provide quality care, offer creative solutions, provide practical and translational leadership, and shift the view of healthcare to create positive outcomes. Background: The goal of the DNP project is to translate evidence into practice to improve healthcare outcomes through direct or indirect care for systems and populations (Murphy, 2018). To effectively assist students in executing a scholarly change project, in the face of the many obstacles within DNP programs, the DNP project process must adopt innovative technologies and seamless education and practice pathways to improve the structure, the process, and outcomes (VanderKooi, 2018). The use of the Lean Six Sigma Framework can be integrated as a quality improvement process to identify the gaps in the DNP project process. It aims to create flow, eliminate waste, improve process capability, and remove variation (Hill, J., e al., 2018). Methods: This was a quality improvement study design. Subjects were recruited via convenience sampling and included DNP (current and alumni) students enrolled in accredited DNP programs. Social media platforms and email communication were used as the setting. Participants were recruited from anywhere in the United States (US), implementing their projects at different facilities. The data collection instrument used to gather and disseminate findings was a 48-question mixed-method survey that combined demographic, multiple-choice, Likert scale, and open-ended questions. There was also a voluntary focus session that consisted of nine open-ended questions. Results: Results concluded that stress derived from the overwhelming nature of the DNP capstone, differing expectations within the program, ineffective communication, and working in isolation were the most significant factors contributing to students\u27 dissatisfaction. Significance: We need to get a deeper understanding of the DNP project process from all key stakeholders (student, faculty, clinical site/preceptor) to ensure a rigorous curriculum, producing sustainable projects aligned with the student\u27s vision. DNP-prepared nurses will be the new leaders for healthcare, and our goal should be to create leaders that will improve the state of our healthcare and improve patient and provider outcomes

Human parvovirus B19 infection and hydrops fetalis in Rio de Janeiro, Brazil

Formalin-fixed paraffin embedded lung and liver tissue from 23 cases of non immune hydrops fetalis and five control cases, in which hydrops were due to syphilis (3) and genetic causes (2), were examined for the presence of human parvovirus B19 by DNA hybridisation. Using in situ hybridisation with a biotynilated probe one positive case was detected. Using 32P-labelled probes in a dot blot assay format, five further positives were obtained. These were all confirmed as positive by a nested polymerase chain reaction assay. Electron microscopy revealed virus in all these five positive cases. The six B19 DNA positive cases of hydrops fetalis were from 1974, 1980, 1982, 1987 and 1988, four of which occurred during the second half of the year, confirming the seasonality of the disease

Where less may be more: how the rare biosphere pulls ecosystems strings

Rare species are increasingly recognized as crucial, yet vulnerable components of Earth’s ecosystems. This is also true for microbial communities, which are typically composed of a high number of relatively rare species. Recent studies have demonstrated that rare species can have an over-proportional role in biogeochemical cycles and may be a hidden driver of microbiome function. In this review, we provide an ecological overview of the rare microbial biosphere, including causes of rarity and the impacts of rare species on ecosystem functioning. We discuss how rare species can have a preponderant role for local biodiversity and species turnover with rarity potentially bound to phylogenetically conserved features. Rare microbes may therefore be overlooked keystone species regulating the functioning of host-associated, terrestrial and aquatic environments. We conclude this review with recommendations to guide scientists interested in investigating this rapidly emerging research area

The causes and consequences of microbial community structure

The causes and consequences of differences in microbial community structure, defined here as the relative proportions of rare and abundant organisms within a community, are poorly understood. Articles in "The Causes and Consequences of Microbial Community Structure", use empirical or modeling approaches as well as literature reviews to enrich our mechanistic understanding of the controls over the relationship between community structure and ecosystem processes. Specifically, authors address the role of trait distributions and tradeoffs, species-species interactions, evolutionary dynamics, community assembly processes and physical controls in affecting ‘who’s there’ and ‘what they are doing’