Assignment on The DNP Project: Literature Synthesis

SECTION I: PRACTICUM APPLICATION
Please type your responses to all questions under this section and upload as an attachment to your online practicum
application. Note that scanned or handwritten submissions will not be accepted.
Student Name:________________________________________________________Student ID (D#): _____________________________
Email: ______________________________________________________________Phone: ___________________________________
Address: _____________________________________________________________________________________________________
❑I fully understand I cannot collect any data and/or implement my project at the practicum site until my proposal is approved and I have received
all required permission(s) from Chamberlain’s Institutional Review Board (IRB), as well as the practicum site’s IRB (if applicable).
Working Project Title: ____________________________________________________________________________________________
Practicum Site/Organization Name: __________________________________________________________________________________
Practicum Site Contact Person: _____________________________________________________________________________________
Name, email address, phone
Preceptor Contact Information: _____________________________________________________________________________________
Name, credentials, email address, phone
Mentor Contact Information: _______________________________________________________________________________________
Name, credentials, email address, phone
Practicum Site Key Decision Maker(s) Contact Information: _________________________________________________________________
Name, credentials, email address, phone
Date(s) you spoke to Practicum Site Key Decision Maker(s): _________________________________________________________________
After you communicated with the practicum site decision maker(s), what issue/problem did they state they want you to work on as part of your DNP
practicum?
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Do you have a letter of support for your proposed project? Note this must be obtained prior to starting NR702 and be communicated via the practicum
site’s letterhead, as well as signed by the decision-maker. Please refer to the Resources section within your didactic course for a sample letter.
❑Yes ❑No Comments ____________________________________________________________________________________
Select if your project is using a translational science model or a theoretical framework and change model. Identify model used.
❑Translational Science Model – define:
❑Framework/Change Model – define:
-UPLOAD AS AN ATTACHMENT TO YOUR ONLINE PRACTICUM APPLICATIONCOLLEGE of NURSING
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Please visit chamberlain.edu/locations for location specific address, phone and fax information.
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DNP PRACTICUM FORM
SECTION 2A: PROJECT NAVIGATION
Work with your assigned Project Navigator to answer all questions under this section in preparation for your
upcoming Practicum experience.
Provide a problem statement (no less than 5-6 fully structured sentences) to explain the issue/problem you are addressing. Please describe current
practice/process leading to the issue. Provide any reports or currently available data to document the need identified by primary decision maker(s) at
practicum site. NOTE: in this section, you must include in-text citations with your evidence-based intervention.
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Provide a brief description, using in-text citations/references, to support the need for change from both a global and practicum site perspective.
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What is the purpose of your proposed project? Begin your formal purpose statement by stating, “The purpose of the proposed DNP project is to…”
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Based on the needs of the practicum site, please provide your one-sentence PICOT question below in a clear and concise manner. Note: Your
the population cannot be students or faculty; your intervention cannot be educational and your time-frame must be 8-10 weeks.
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Fully describe the population (keep in mind students and/or faculty are not allowed) of your proposed project. What is your anticipated sample size
and what inclusion and exclusion criteria will be used to identify your population?
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COLLEGE of NURSING
National Management Office | 3005 Highland Parkway, Downers Grove, IL 60515 | 888.556.8226 | chamberlain.edu
Please visit chamberlain.edu/locations for location-specific address, phone, and fax information.
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DNP PRACTICUM FORM
Note: You are required to have a minimum of 10-12 contemporary research articles (< 5 years old) to support your evidence-based practice (EBP)
intervention. Please provide a full listing (APA formatted) of the evidence you have to support the EBP intervention you will implement.
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Explain the intervention you will implement to address the issue identified based on the needs of the practicum site. Remember, educational
only interventions are not allowed. The intervention should be based on the translational science model you have chosen. You must provide an
overview of the intervention so the reader(s) will be able to duplicate the intervention on their own. (Include or attach any relevant documents,
if available such as protocols, procedures, guidelines, etc. that you will implement).
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Given you only have 8-10 weeks to implement your project, discuss its feasibility. Will you be able to acc