Integrating JBI evidence implementation training into Doctor of Nursing Practice curricula

In the ever-evolving healthcare landscape, quality improvement (QI) has emerged as a fundamental framework to enhance patient care, optimise outcomes and elevate the healthcare experience. QI is not only for experienced healthcare professionals but also for students, such as those in a Doctor of Nursing Practice (DNP) program. The DNP program equips nursing professionals with advanced knowledge and skills to lead, manage and innovate in healthcare settings.

Benefits of QI in nursing practice

QI initiatives in nursing practice offer numerous benefits, such as better patient outcomes, greater patient satisfaction and optimised healthcare delivery. These benefits align with the DNP program's goals, emphasising advanced practice and leadership. For DNP students, engaging in QI enhances their clinical decision-making skills and fosters a mindset of continuous learning and innovation. Integrating QI principles and methodologies into DNP education is vital to prepare future nursing leaders for the realities of healthcare practice. Hands-on engagement in real-world QI projects enables DNP students to apply theoretical knowledge to practical scenarios, fostering a deeper understanding of the challenges and rewards of driving change in healthcare settings. 

Integration of the JBI Evidence Implementation Training Program into the DNP curriculum

The JBI Evidence Implementation Training Program (EITP) is a 6-month, evidence-based implementation program comprising two intensive training workshops and an evidence implementation project carried out in the clinical setting in the interim months. The two workshops give participants practical strategies for putting evidence into practice as well as the information, resources and tools they need to conduct an evidence implementation project in their own clinical setting. The audit and feedback method taught in the EITP is frequently used to enhance professional practice, either alone or as part of multidimensional QI efforts. 

In 2021, the University of Mississippi Medical Center School of Nursing (UMMC SON) integrated the EITP into the DNP curriculum. As part of their tuition, DNP students pay a JBI fee, which is used for EITP enrolment fees, and each phase of the EITP is built into coursework over 4 or 5 semesters, depending on the student's full-time or part-time status. The students’ electronic learning management system houses resources for each phase of the project and submission locations for assignments. 

During the first spring semester of their DNP program (course number DNP 702-1), students choose a clinical site with an area of non-compliance with evidence-based guidelines. Then, they work with their faculty advisor to complete and submit JBI’s EITP Topic Request Form. The following summer semester (course DNP 712, Credit 1), the students attend Week 1 of the EITP and conduct phases 1-4 of their evidence improvement projects with faculty guidance. The students submit assignments during this semester, which include: (1) an audit criteria table that outlines their audit criteria provided by JBI, an audit sample, methods used to measure compliance with best practices, and an audit guide; and (2) their baseline audit report utilising JBI PACES (Practical Application of Clinical Evidence System). 

In the fall semester (DNP 712, Credits 2 and 3), students conduct phases 5-7 of their evidence improvement project and submit (1) a Getting Research into Practice (GRiP) table and (2) their post-implementation audit report from JBI PACES. They also begin submitting sections of their evidence improvement project report to faculty, using the JBI template, for feedback and revision. Students are expected to integrate feedback from faculty into each evidence improvement project report submission and continue building upon previous versions. 

The following spring semester (DNP 712, Credit 4 if part-time or Credits 4 and 5 if full-time), students attend Week 2 of the EITP, where they continue to finesse their evidence improvement project reports and collaborate with faculty. By the end of the semester, they submit their reports to the journal, JBI Evidence Implementation. Additionally, students are required to submit an abstract to the UMMC SON Research and Scholarship Day for a potential poster or podium presentation. 

Part-time students who take their fifth credit of DNP 712 in the summer receive peer-reviewed feedback for their submission to JBI and continue to work with their faculty advisor on requested edits for publication, if applicable. Figure 1 details the EITP curriculum integration. 

Figure 1: Curriculum integration

Since integration into the curriculum, 25 DNP students have completed the EITP and submitted evidence improvement project reports to the journal. The first cohort of students (n=12) achieved a 75% publication rate, while the second cohort (n=14) submitted reports for publication. Although we do not have complete data for the cohort, seven students’ reports have already been accepted for publication. Positive patient and organisational outcomes are achieved with the evidence improvement projects, and the DNP students receive real-world experience in translating evidence into practice, which they will continue to use to promote the vision of JBI.

A webinar was recently presented by the authors, which provides a more in-depth overview of the initiative. 

QI is the cornerstone of enhancing patient care, reducing healthcare disparities and driving innovative changes.  DNP students, equipped with advanced clinical knowledge and leadership skills, are pivotal in advancing the QI process. By embracing the challenges and rewards of QI, DNP students exemplify the transformative impact of nursing professionals in shaping the future of healthcare. 

Authors

Professor Robin Christian 
Professor of Nursing, School of Nursing 
Director, Mississippi Centre of Evidence-Based Practice: A JBI Centre of Excellence and US Cochrane Affiliate 
University of Mississippi Medical Center 
Jackson, MI, USA 

Associate Professor Michelle Palokas 
Assistant Dean for Accreditation and Evaluation 
Associate Professor of Nursing, School of Nursing 
Deputy Director, Mississippi Centre of Evidence-Based Practice: A JBI Centre of Excellence and US Cochrane Affiliate 
University of Mississippi Medical Center 
Jackson, MI, USA