Understanding the DNP Capstone Writing Process

In nursing, doctorate programs are either research or practice-focused. Research-focused programs are designed to prepare nurse scholars and scientists. Practice-focused programs prepare experts in advanced nursing practice and focus on evidence-based approaches. Students in practice-focused programs are required to develop scholarly Doctor of Nursing Practice (DNP) projects that are based on the institution’s guidelines. The capstone project provides nurses with an opportunity to translate the knowledge acquired into practice. This article contains guidelines for writing an exemplary DNP scholarly project that is based on evidence and focused on promoting patient and/or improving practice outcomes.

The Procedure for Developing a DNP Scholarly Capstone Project

In the increasingly complex and dynamic healthcare system, the DNP project prepares nurses to be able to apply evidence-based practices to improve patient outcomes, decrease the per capita cost, and promote the health of a population. The DNP projects should be developed as a testament to the knowledge acquired from the curriculum in relevance to the practice. It is indispensable for the developed DNP project to (a) emphasize on a change that has an impact on the healthcare outcomes through direct or indirect care; (b) focus on a population or system at the micro, meso, or macro system level; (c) feasible in terms of implementing the specific area of practice; (d) be sustainable; (e) contain an evaluation process to determine the clinical significance of the outcomes; and (f) provide a foundation for future scholarship. The procedure of developing a DNP project includes preliminary planning and formulating the chapters.

Planning

The DNP scholarly project should be relevant to the doctorate candidates’ course of study, focus on areas that support nursing and healthcare, and based on the students’ interest. The planning stage involves developing the scope of the project, conducting a synthesis of the literature, formulating a clinical question, and determining the research methodology and study design.

The first step of determining the scope of the project requires the DNP candidate to choose the patient group or population of interest and decide whether to focus on quality improvement, organizations, models of care, systems, community care, or cost analysis concepts. The universities’ websites and professional organizations, such as the National Organization of Nurse Practitioner Faculties (NONPF) and National Database of Nursing Quality Indicators (NDNQI), provide resources that students enrolled in DNP programs can use to determine the scope of their scholarly projects. Alternatively, conducting a needs assessment at a target or healthcare facility of practice can help a DNP candidate in formulating a relevant and feasible scope of the project.

In regards to determining whether the project should be based on clinical practice, intervention, policy, or patient safety, the second step involves conducting a search for literature on credible databases and analyzing the retrieved articles. Evaluating and appraising the content of the articles retrieved should be conducted systematically to facilitate in increasing understanding of the problem, background and prevalence of the issue, gaps in research, and possible solutions or existing interventions. At this second stage, a DNP student should select the theoretical framework that will guide the project and identify the current and desired outcomes.

The third step involves the development of a clinical question that adheres to the Patient, Intervention, Comparison, Outcome, and Time (PICOT) framework. Fourth, the DNP candidate is then required to identify the most appropriate and rigorous methodology and design that will facilitate in collecting data that will help in answering the clinical question or hypotheses developed, and minimize biases or threats to internal, construct, and external validity. Although not all the eight essentials have to be demonstrated in the DNP project, it is indispensable that considers their applicability during planning because they influence the outcome of the program.

Formulating Chapter One to Five of the Capstone

At the end of the planning stage, a DNP student should have a clinical question, theoretical framework, and compelling topic that suggests the core variables of the project and study population. The formulation stage is dependent on the outcomes of the planning stage. After receiving permission from the committee, advisors, mentors, or reviewers to proceed with the topic, the DNP candidate should apply for approval from the Institutional Review Board (IRB) and target agency before commencing on writing the proposal.

The students should start writing the scholarly project that should contain chapters one, two, three, four, and five based on the university’s toolkit and rubric only after receiving IRB approval and permission from the target facility. Chapters one to three are considered as the DNP project proposal and are first written in future tense because the implementation has not yet occurred. Conversely, after implementation, chapters one to three are converted into the past tense, and sections four and five are included to make the manuscript a DNP project.

Chapter one should be written in a coherent manner to provide introductory information, background content starting with a global perspective and systematically narrowing to the micro setting, and a justification for the need to conduct the scholarly project in the form of a problem and purpose statement. The second chapter should contain an explanation of the theoretical framework and a review of the literature.

The operational and conceptual concepts of the project should be applied in a congruent manner. The second chapter should contain a search strategy discussing the databases, keywords, Boolean operators, Medical Subject Headings (MeSH), and search phrases applied to retrieve the peer-reviewed articles. In addition, the articles retrieved should be synthesized in an orderly, cohesive, well-sequenced manner in the form of themes and sub-themes.

Chapter three should contain a discussion of the methodology, and sufficient details should be provided to facilitate replication of the study in different settings. The chapter should contain a discussion of the study design, population and sample, intervention, data collection, and data analysis.

The fourth chapter should include the participants’ demographics and the findings that may be presented in the form of tables, charts, graphs, and/or figures. The fifth chapter should contain a discussion of the findings, implications, future research recommendations, sustainability, limitations, application to the DNP essentials, the techniques for dissemination, and conclusions. In addition, an abstract providing a coherent summary of the problem, purpose, methodology, design, findings, and the conclusion of the study should be included before the first chapter. After completing the write-up, one should edit and proofread the DNP capstone keenly to ensure that it has no errors.

Summary

The development of DNP projects helps nurses in applying their knowledge to translate research into practice. The projects provide the students with an opportunity to apply principles of evidence-based practices to solve identified clinical problems. All DNP projects should result in the improvement of healthcare outcomes; focus on a population or system; and be feasible, sustainable, measurable, and based on evidence. The two core steps for developing a DNP project that is based on evidence and focused on improving the patients or practice outcomes include preliminary planning and formulation of chapters. Planning involves determining the scope of the project, searching for empirical evidence, creating a clinical question, and identifying the most applicable methodology and study design. A DNP project should have five chapters that include the introduction, literature review, methodology, findings, discussion, and conclusion. The content and name of the chapter can vary depending on the university. Thus, it is indispensable to review the institution’s project toolkit, template, and rubric. See more details on how you can obtain expert help in writing your DNP project.