What the DNP project is
The DNP project is a scholarly practice-improvement project, usually implemented in a real clinical setting, that demonstrates translation of evidence into practice. It differs from a PhD dissertation: the aim is to improve practice and outcomes in a specific setting, and to evaluate the effect, not to generate new theory. Programs vary in format, so use your handbook, but most proposals cover the same components.
| Component | Purpose |
|---|---|
| Problem and significance | Show a gap in practice, with local data and national evidence |
| PICOT question | State the population, intervention, comparison, outcome and time |
| Evidence synthesis | Appraise and summarize the best available evidence |
| Framework | Guide the translation process |
| Project design | Setting, participants, intervention, timeline |
| Measures and analysis | Outcomes, data collection, statistical or descriptive analysis |
| Ethics and approvals | IRB review or determination, consent, data protection |
| Budget and sustainability | Resources, cost-benefit and plan to maintain |
Write a PICOT question
PICOT organizes a clinical question into parts: Population, Intervention, Comparison, Outcome and Time. A good one is narrow and measurable.
PICOT (hypothetical)
In adults with type 2 diabetes and elevated HbA1c in a primary care clinic (P), does a nurse-led telehealth coaching program (I) compared with usual care alone (C) lower HbA1c (O) within 12 weeks (T)?
| Element | Example | Check |
|---|---|---|
| Population | Adults 18 to 75 with HbA1c above 8.0 percent | Specific, defined by criteria |
| Intervention | Six telehealth coaching sessions | Described so it can be repeated |
| Comparison | Usual care or the same patients before the project | Matches the design |
| Outcome | Change in HbA1c | Measurable with a validated tool |
| Time | 12 weeks | Realistic for effect |
If your design is a single-group pre and post test, the comparison is the baseline. Be honest about the limits of that design.
Appraise and synthesize the evidence
Search systematically (CINAHL, PubMed, Cochrane Library and others), record your search terms and inclusion criteria and appraise each source for quality using an accepted tool and a hierarchy of evidence. Summarize in a table that lets a reader see the strength of the evidence at a glance.
| Source | Design | Sample | Key finding | Level and quality |
|---|---|---|---|---|
| Author A (year) | Randomized trial | 240 adults | Coaching lowered HbA1c by 0.6 points | High |
| Author B (year) | Systematic review | 14 studies | Telehealth coaching improves glycemic control | High |
| Author C (year) | Quasi-experimental | 85 adults | Improvement, attrition at 20 percent | Moderate |
Synthesize rather than summarize: say what the body of evidence agrees on, where it conflicts and how well it fits your setting. See our literature review guide for synthesis technique.
Choose a framework and design
A framework gives the project structure. Common choices include the Iowa Model of evidence-based practice, the Johns Hopkins nursing evidence-based practice model, the Plan-Do-Study-Act cycle, the Knowledge-to-Action framework and Rogers' diffusion of innovations. Name your choice and map each phase of the project to a step in the model.
| Design element | What to specify |
|---|---|
| Setting | Clinic or unit, patient volume, staffing |
| Participants | Inclusion and exclusion criteria; expected sample |
| Intervention | Content, dose, who delivers, training of staff |
| Timeline | Preparation, implementation, data collection, analysis |
| Stakeholders | Sponsor, clinic leaders, staff, patients |
| Fidelity | How you will check the intervention was delivered as planned |
Measures and analysis, with a worked example
Choose measures before the project starts, with validated tools where possible, and plan the analysis. For a small before-and-after design, a paired t-test compares each participant's baseline and follow-up.
Paired comparison (hypothetical)
40 patients complete the program. Mean HbA1c falls from 9.2 percent to 8.6 percent, a mean difference of 0.6. The standard deviation of the individual differences is 1.2.
Standard error = 1.2 / square root of 40 = 1.2 / 6.325 = 0.19. t = 0.6 / 0.19 = 3.16 with 39 degrees of freedom, so p = .003.
Effect size (standardized mean change) = 0.6 / 1.2 = 0.50, a medium effect. Clinically, a reduction of 0.6 points is meaningful for glycemic control but should be interpreted against established clinical targets.
Report statistical and clinical significance, and be honest about the limits of a design with no control group: improvement may reflect other influences, such as regression to the mean or changes in medication. Include process measures (sessions completed, fidelity) and balancing measures (staff time, patient burden). For reporting, see our guide to the data analysis chapter.
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Get an instant quoteA logic model for the project
A logic model shows how resources become results and keeps the project coherent.
| Component | Example (telehealth coaching for diabetes) |
|---|---|
| Inputs | Nurse practitioner time, telehealth platform, coaching curriculum, clinic support, funding $4,500 |
| Activities | Staff training; recruit 40 patients; six coaching sessions per patient over 12 weeks |
| Outputs | Sessions delivered; number of patients completing; fidelity checklist scores |
| Short-term outcomes | Improved self-management knowledge; HbA1c change at 12 weeks |
| Longer-term outcomes | Sustained glycemic control; fewer emergency visits; program adopted by the clinic |
| Assumptions and context | Patients have internet access; clinic leadership supports protected time |
Check each arrow: do the activities plausibly produce the outputs, and do the outputs plausibly lead to the outcomes? Weak links point to risks or to parts of the plan that need more evidence.
Levels of evidence
| Level | Typical source | Comment |
|---|---|---|
| High | Systematic reviews and randomized trials | Strongest for effectiveness of an intervention |
| Moderate | Quasi-experimental and cohort studies | Useful, with more risk of bias |
| Lower | Case studies, expert opinion, clinical guidelines based on consensus | Valuable when higher evidence is absent; say so |
Different programs use different grading systems, so follow the tool your course requires, state the level for each source and explain how the overall strength of the evidence supports your choice of intervention.
Sustainability, dissemination and next steps
- Embed in workflow Add the intervention to standard visit templates or protocols.
- Train and name champions People who keep the practice alive after the project ends.
- Add measures to routine reporting So results continue to be seen by leaders.
- Share results Present to the clinic, organization and, where appropriate, at a conference or in a journal.
- Plan the next cycle What to change or scale based on what you learned.
Close the proposal with a short statement of how the project meets the program's expectations for practice change, evidence use, and leadership, since examiners check against those outcomes.
Ethics, budget and sustainability
Many programs require the project to be reviewed by an institutional review board to determine whether it is quality improvement or research; follow your institution's process and obtain letters of support from the site. Protect privacy: use de-identified data, secure storage and limited access.
| Budget item | Estimate (hypothetical) |
|---|---|
| Staff training time (10 staff x 4 hours x $45) | $1,800 |
| Telehealth platform and supplies | $2,400 |
| Printed materials | $300 |
| Total | $4,500 |
Show the expected benefit, such as fewer visits or avoided complications, using cited costs, and explain how the program will continue after the project ends: embed it in clinic workflow, train champions, add measures to routine reporting and assign an owner.
- Make the PICOT tight A narrow, measurable question.
- Appraise the evidence A table, with quality ratings and a synthesis.
- Map the project to a framework Each phase to a step.
- Choose measures first Outcome, process and balancing.
- Plan ethics and sustainability Approvals, budget and a maintenance plan.
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