Direct Practice Improvement (DPI) Project Proposal Chapter 1 – Introduction to the Project Chapter 1 of the Direct Practice Improvement (DPI) Project is titled “Introduction to the Project” and includ

Direct Practice Improvement (DPI) Project Proposal Chapter 1 – Introduction to the Project

Chapter 1 of the Direct Practice Improvement (DPI) Project is titled “Introduction to the Project” and includes background and other essential information regarding the overall DPI Project design and components.

TOPIC: Impacts of Medication Administration Error on Three to Four years-old Leukemia Patients

General Requirements:

Use the following information to ensure successful completion of the assignment:

  • Locate the “DPI Proposal Template” located in the PI Workspace of the DC Network.
  • Access the textbook “The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing textbook. Chapter 10 of this textbook provides an excellent template for a DNP-focused scholarly project.
  • Access examples of DPI projects in the DC network DNP Practice Immersion Space
  • Doctoral learners are required to use APA style for their writing assignments.
  • This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
  • You are required to submit this assignment to LopesWrite.


Use the “DPI Proposal Template” to help you develop a draft of the Introduction (Chapter 1) of your DPI Project Proposal. Keep in mind this is an outline and formatting structure; it may be of use to you, but recall that each project will vary in nature and scope, so adaptations to this format may be required.

Please use the attached sample to understand what is required. Only written words are required and not a full Prospectus

Sections in Chapter 1 include:

1. Chapter 1: Introduction to the Project

2. Background of the Project

3. Problem Statement

4. Purpose of the Project

5. Clinical Question(s)

6. Advancing Scientific Knowledge

7. Significance of the Project

8. Rationale for Methodology

9. Nature of the Project Design

10. Definition of Terms

11. Assumptions, Limitations, Delimitations

12. Summary and Organization of the Remainder of the Project

Much of this information can be gleaned from your DPI Prospectus and 10 Strategic Points, but you will find that new as well as expanded content in specific areas will be required, depending on the nature of your proposed DPI Project.

Direct Practice Improvement (DPI) Project Proposal Chapter 1 – Introduction to the Project Chapter 1 of the Direct Practice Improvement (DPI) Project is titled “Introduction to the Project” and includ
Dissertation Prospectus Topic Submitted by: Date The Prospectus Overview and Instructions Prospectus Instructions: Read the entire Prospectus Template to understand the requirements for writing your prospectus. Each section contains a narrative overview of what should be included in the section and a table with required criteria for each section. WRITE TO THE CRITERIA, as they will be used to assess the prospectus for overall quality and feasibility of your proposed research study. As you draft each section, delete the narrative instructions and insert your work related to that section. Use the criterion table for each section to ensure that you address the requirements for that particular section. Do not delete/remove the criterion table as this is used by you and your committee to evaluate your prospectus. Prior to submitting your prospectus for review by your chair or methodologist, use the criteria table for each section to complete a realistic self-evaluation, inserting what you believe is your score for each listed criterion into the Learner Self-Evaluation column. This is an exercise in self-evaluation and critical reflection, and to ensure that you completed all sections, addressing all required criteria for that section. The scoring for the criteria ranges from a 0-3 as defined below. Complete a realistic and thoughtful evaluation of your work. Your chair and methodologist will also use the criterion tables to evaluate your work. Your Prospectus should be no longer than 6-10 pages when the tables are deleted. Score Assessment 0 Item Not Present 1 Item is Present. Does Not Meet Expectations. Revisions are Required: Not all components are present. Large gaps are present in the components that leave the reader with significant questions. All items scored at 1 must be addressed by learner per reviewer comments. 2 Item is Acceptable. Meets Expectations. Some Revisions May Be Required Now or in the Future. Component is present and adequate. Small gaps are present that leave the reader with questions. Any item scored at 2 must be addressed by the learner per the reviewer comments. 3 Item Exceeds Expectations. No Revisions Required. Component is addressed clearly and comprehensively. No gaps are present that leave the reader with questions. No changes required. Dissertation Prospectus Introduction The Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Justice, every year in the United States, millions of people suffer from mental illness. The high numbers necessitate raising public awareness and start campaigning for a much better health care system (, 2016). In 2018, 47.6 million people in the U.S. experienced mental illness which means 1 in every 5 adults. 11.4 million Adults between ages 25 and 35 had an episode of serious mental illness. In 2016, 7.7 million youths aged 6-17 experienced some sort of mental health disorder, while 9.2 million people were reported to have experienced substance use disorder (National Alliance on Mental Illness, 2019). The health sector in this Southern State has been applauded for the good work in health allocations and expenditures. However, despite all the expenditures and better services offered to the people living in the county, mental health sector still faces challenges, especially among many Asian and African American people living in the county who have little to no access and utilization of the services within the region (Texas, 2017). This has been attributed to a number of factors which hinder most people from accessing mental health services. In addition, the results of the studies conducted on the mental health care in the country have shown that the issuance of mental health services has a big gap among the different cultures, but mostly affecting the minority groups in the nation. The most difficult challenge that was established was the improvement of mental health especially among the minority groups such as the Asian Americans and the African Americans. In most reported cases, many people are dying and committing suicide as a result of not properly utilizing mental illness health services and lack of insurance coverage. One Southern State County has been recognized as one of the counties where the utilization of mental health facilities is below the expected standards. Although the county is one of the areas with the highest and the best health facilities, yet, the county still faces a lot of challenges on the number of children with mental health challenges. The study will be conducted on the people, who are basically African Americans, Asian Americans and the Caucasian citizens of the county, that were affected by lack of mental health services. The high mental health cases in this Southern State County are blamed on various factors. One of the factors is the lack of enough and well-trained mental health professionals within the county. Such has resulted to lack of utilization of the mental health facilities hence the rising number of mentally challenged children. Poverty levels in the county have also been blamed for the increased number of mentally challenged children. Most of the people in the county have low income and cannot afford insurance hence lacking the access to mental healthcare. Caregivers in the mental healthcare clinics in this county, agreed that many people in the county laced knowledge about the mental healthcare because of their low social status within the county. Also, they acknowledged that they lacked enough knowledge about the importance of mental healthcare. This is a research study aimed at discussing the factors influencing individuals’ decision not to utilize mental health services in a Southern State County. The study is important in understanding the major reasons which limit utilization of mental health services in the county and recommending ways through which the issues can be resolved. Criteria Learner Self-Evaluation Score (0-3) Chair Evaluation Score (0-3) Reviewer Score (0-3) Introduction This section briefly overviews the research focus or problem, why this study is worth conducting, and how this study will be completed. The recommended length for this section is two to three paragraphs. Dissertation topic is introduced along with why the study is needed. Provides a summary of results from the prior empirical research on the topic. Using results, societal needs, recommendations for further study, or needs identified in three to five research studies (primarily from the last three years), the learner identifies the stated need, called a gap Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. NOTE: This Introduction section elaborates on the Topic from the 10 Strategic Points. This Introduction section provides the foundation for the Introduction section in Chapter 1 of the Proposal. Reviewer Comments: Background of the Problem The objectives of this prospectus are to examine the factors influencing individuals’ decision to not utilize mental health in one Southern State County. Previous research works have explored the field of health accessibility not only in Texas but throughout the country. When narrowing down to this county, research has shown a gap alignment of medical services and needs of the people living in the county. Children at Risk (2017) deliberate on various increasing children with mental disorders’ needs in the society. Most of them develop mental illness from birth. Though the county has been applauded for having the best health services, the area still faces a number of challenges which are a threat to the child-health. Access to mental health is a gap yet to be filled in Fort bend (Beatty, Wilson, Ciecior, & Stringer, 2015). This has been fueled by few mental health professionals in Texas which has led to poor infrastructure in the mental health sector. The sectors greatly affected are the juvenile systems and emergency facilities. Many people in the region are uninsured and also have lower income which makes it had for them to get mental health services. In addition, poor parenting was a great contributor of health illness. This calls for further research into the field to understand more factors which affects the utilization of mental-health services in the areas not only in children but all people of this Southern State County. According to the Centers for Disease Control and Prevention, mental health has become a significant public health issue in the United States that requires immediate attention and must be diagnosed at its early stages. Without an early diagnosis and treatment, children and adolescents may experience problems in the home, at school and among friends including issues with forming friendships. Accordingly, researchers have explored some barriers relating to the utilization of mental health service, notwithstanding, there were other factors that may also influence individuals’ decision to not utilize mental health. Caregivers are primarily the means by which most people including children and adolescents as well as adults enter treatment. They are responsible for taking care of their patients/clients physical and emotional well-being. The objective here is to specifically explore any relationship existing in utilizing mental health services and the influences of caregivers, including burden, caregiver mental health status and caregiver type. The study is a cross-sectional and utilizes secondary analysis of the 2003 National Survey of Children’s Health of 3,986 children and adolescents ages 6-17 with mental health needs. To understand caregiver influences and their characteristics as it relates to the relationship between need and utilization of mental health services, a bivariate and multivariate analyses were conducted (Grayson, 2016). Results indicates that experienced caregivers who encounter some level of burden may likely utilize mental services than others who do not experience any burden. Caregivers that experience high level of burden will likely 15 times or more utilize mental health services (OR =13.70; 95% CI 10.58-17.74, p<0.001). Similarly, the caregivers that experience serious signs of depression or anxiety in their child or adolescent (OR=1.55; 95% CI 1.21-1.98; p<0.05) will tend to use the services more than the caregivers who experience mild or no sign of depression or anxiety. The mental health status of the caregiver is of no significance and has no influence on need and utilization (Grayson, 2016). Teenagers in the age range of 14 to 17 are significant and are found to utilize mental health services more than the younger ones (OR=1.48; 95% CI1.16-1.89; p<0.05). African American children use mental health services more than the Caucasian Hispanic or other children (OR=0.59; 95% CI 0.38-0.91; p<0.05). The income and the caregivers have no influence on utilization. Furthermore, individuals with insurance coverage tend to use mental health services more than those without coverage (OR=1.88; 95% CI 1.22-2.64; p<0.05). The findings of this research indicate that caregivers are important for people to get mental health treatment for their loved ones; in addition, to how caregivers may be barriers to people with need. Furthermore, this study is promoting the need for more studies to include qualitative research to fully understand extra issues and challenges that caregivers and people face while trying to get mental health treatment (Grayson, 2016). Similarly, in their 2015 research analysis, Augsberger, Yeung, Dougher, & Hahm (2015), analyzed the hidden barriers to accessing care and utilization of mental health for Asian American Women in the county. It showed that 299 women representing 43% of the participants have suffered from symptoms of depression or have had suicidal attempts. It examined the mismatch between available services and cultural needs, contribution of Asian society to mental health and contribution of Asian family to the stigma of mental health. Hamilton, Desai, Hoot, Gearing, Jeong, Meyer, & Begley (2016), did research on the factors that affect mental healthcare access among African Americans. They identified one of the reasons to be low income and lack of awareness about the existing institutions that offer mental healthcare. Augsberger, Yeung, Dougher, & Hahm (2015), identified further issues that affect the accessibility of mental healthcare among Asian American women in the county. Accordingly, the authors concluded in their research that the Asian American women are suffering from depression and often were faced with the thoughts of suicide. According to the authors, Asian American women were stigmatized because of the mental health issues, and most of them do not want to come out and seek treatment. Misra, S. M., Guffey, D., Roth, I., & Giardino, A. P. (2017) in their article “Complementary and Alternative Medicine use in Uninsured Children in Texas”, the authors describe the concept relating to the use of complementary and alternative medicine (CAM) for mental health treatment among children in this Southern State County. According to the authors, CAM use among US children stands at 12%. According to the 2012 National Health Interview Study. The research suggests that there are a number of uninsured population due to their limited access to care, which resulted in higher CAM use. A survey of 250 uninsured patients at various pediatric facilities in a free mobile clinic program showed a very high use by Hispanic population, their rate of CAM use in the last 12 months was close to 50% among children and 60% among parents. One Southern State has placed a lot of effort into improving the health care treatment of children; according to that 2012 research report conducted a study National Health Interview Study. Research study suggests that facilities that the services offered are inversely proportional to the allocation provided. Misra and the rest have concluded that this issue has raised a lot of concern since the mental health of the people remain to be very low despite the efforts implanted. Research showed that some institutions have released a lot of funds to run this sector. This research also showed that this Sothern State receive the second largest allocation for mental health. Based on the data collected, a gap was identified regarding the factors that affect the utilization of Mental health facilities within the county. Various people within the mental healthcare profession have done research on some factors that may deter people from receiving mental healthcare. The literature on the mental health gap in the county has revealed major reasons as to why the gap exists. Stigmatization and low income are some reasons as to why the gap exists in the county. Criteria Learner Self-Evaluation Score (0-3) Chair or Score (0-3) Reviewer Score (0-3) Background of the Problem This section uses the literature to provide the reader with a definition and statement of the research gap and problem the study will address. This section further presents a brief historical perspective of when the problem started and how it has evolved over time. The recommended length for this section is two-three paragraphs. Includes a brief discussion demonstrating how literature has established the gap and a clear statement informing the reader of the gap. 1 Discusses how the “need” or “defined gap” has evolved historically into the current problem or opportunity to be addressed by the proposed study (citing seminal and/or current research). 1 ALIGNMENT: The problem statement for the dissertation will be developed from and justified by the “need” or “defined gap” that is described in this section and supported by the empirical research literature published within the past 3-5 years. 2 Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. 2 NOTE: This Background of the Problem section uses information from the Literature Review in the 10 Strategic Points. This Background of the Problem section becomes the Background of the Study in Note, this section develops the foundation for Chapter 1 in the Proposal. It is then expanded to develop the comprehensive Background to the Problem section and Identification of the GAP sections in Chapter 2 (Literature Review) in the Proposal. Reviewer Comments: Theoretical Foundations/Conceptual Framework and Review of the Literature/Themes Theoretical literature There is the need to understand the consequences of not utilizing mental health as it evolved historically. Mental health services in this Southern State has faced several challenges. Texas (2017) asserts that people suffering from mental illness still faces problems despite the huge costs that are directed towards the healthcare. Schwartz, (2017) in support of this Southern State argue that the increased growth-rate of populations in one specific county located in a Southern State has impacted the health sector at large. The high population together with economic constrains has led to few medical insurances which limits access to health. The access to, and utilization of mental health care for the populations living in this county has created a gap within the county (Children at Risk, 2013). Review of the Literature Empirical Approach: Emphasized the issues of underutilized mental health resources and non-institutionalized adults as behavioral risk factors in Southern Texas. (Augsberger, Yeung, Dougher, & Hahm, 2015; Basu, Rehkopf, Siddiqi, Glymour, & Kawachi, 2016; De Luca, Blosnich, Hentschel, King, & Amen, 2016; Hamilton, Desai, Hoot, Gearing, Jeong, Meyer, & Begley, (2016). Augsberger, Yeung, Dougher, & Hahm (2015) identified various issues such as the history of suicide thoughts and depression among the Asian American women, different cultural needs in this specific Southern State county. There are identifying facts suggesting that certain factors are influencing the under-utilization of mental health services among Asian American women with a history of depression and suicide in this county of research. There is also a mismatch between available services and cultural needs, contribution of Asian society to mental health and contribution of families to the stigma of mental health. It concluded and recommended that mental health utilization should not be low among all the cultures, but rather extremely encouraged especially among women in the county (Augsberger, Yeung, Dougher, & Hahm, 2015). Boyer, C., Greenberg, L., Chutuape, K., Walker, B., Monte, D., Kirk, J., & Ellen, J. (2017). Exchange of sex for drugs or money in adolescents and young adults: An examination of sociodemographic factors, HIV-related risk, and community context. Journal of Community Health, 42(1), 90-100. doi:10.1007/s10900-016-0234-2 The purpose of this article is to carry out an assessment on maternal health and the well-being of the child and how it contributes to long term mental health. This mainly focuses on the anal stage especially when the child is born. It lays an emphasis on ensuring an understanding of basic but critical pediatric care. The result was that the hospital was able to ensure that it provides the pediatric care to the critical patients for 24 hours before and after birth. This is to make sure that young and divorced mothers know how to navigate and ensure the provision of proper mental care. Recommendations includes providing classes and courses that to the main practitioners on how to handle new parents and how to guide them into providing the required help to the children who are ill. Goldman D., Robin R. W. & Chester B. (2018), Factors Influencing Utilization of Mental Health and Substance Abuse Services by American Health Institutions The purpose of this article is to study the impact that gender, the number of childhood victimization and psychiatric diagnoses has on the utilization of mental health patients in the Southwestern American Indian community. In its outcome and recommendations, the article declares these factors as the main contributors in the utilization of the substance abuse and mental health when one is coming up with proper treatment interventions. Schwartz, A. (2017). A report on the demographic changes and changing needs of fort bend county University of Texas at Austin. doi:10.15781/T2MC8RZ1M Ariel and Peter gave an analysis of how population growth has affected the health status of people living in this Southern State County. There have been different studies conducted to indicate the mental status of individuals living within the country. In the outcome of the research, this article laid emphasis on the fact that many people in the population are uninsured, and that the economic challenges that the large population is experiencing is responsible in part for what is influencing individuals' decisions to not utilize Mental Health and the extent to which the community healthcare extends its services to every member. Recommendations include training and mentioning healthcare providers and caregivers on improvements that need to be done continually to ensure that the different needs of the growing population are met. Literature Themes Review of the literature review identified the following themes: Lack of proper mental health education and infrastructure has been the major factor affecting the utilization of mental health. Goldman Robin & Chester (2018) in his research found out that women who had been exposed to sexual abuse and drug abuse formed the high numbers of people who utilize mental health services among the Hispanic and non-white people in the county. Augsberger, Yeung, Dougher, & Hahm, (2015) in support of this research argued that mental health services had been underutilized by Asian women living in this county, as a result of both cultural needs and mismatch of the services offered in the health facilities in this Southern State. Lack of medical insurance. Research has shown that many people due to poor economic status has left many people without health insurance as they cannot afford. This limits many average and lower-class families from accessing mental illness services (Children at Risk, 2013). Poor perception among the community members. Researchers reveals that many people who live in this county perceive child mental illness as a mere sign of hunger besides poor diets. This has left many people neglecting utilization of mental healthcare in the community (Children at Risk, 2013). The theoretical model for the research gap is the Vygotsky Social Development Theory. The Social Development theory is a theory done by De Luca et al. Within the theory, the authors propose that unfavorable social conditions and chronic health issues have a role that they play in promoting mental health issues within a certain category of people. Similarly, the authors made a comparison between the utilization of mental health conditions among African Americans, Asian-Americans and the Caucasians in this Southern State County. Criteria Learner Self-Evaluation Score (0-3) Chair or Score (0-3) Reviewer Score (0-3) Theoretical Foundations and/or Conceptual Framework This section identifies the theory(s) or model(s) that provide the foundation for the research. This section should present the theory(s) or models(s) and explain how the problem under investigation relates to the theory or model. The theory(s) or models(s) guide the research questions and justify what is being measured (variables) as well as how those variables are related (quantitative) or the phenomena being investigated (qualitative). Review of the Literature/Themes This section provides a broad, balanced overview of the existing literature related to the proposed research topic. It describes the literature in related topic areas and its relevance to the proposed research topic findings, providing a short 3-4 sentence description of each theme and identifies its relevance to the research problem supporting it with at least two citations from the empirical literature from the past 3-5 years. The recommended length for this section is 1 paragraph for Theoretical Foundations and a bulleted list for Literature Themes section. Theoretical Foundations section identifies the theory(s), model(s) relevant to the variables (quantitative study) or phenomenon (qualitative study). This section should explain how the study topic or problem coming out of the “need” or “defined gap” in the as described in the Background to the Problem section relates to the theory(s) or model(s) presented in this section. (One paragraph) 1 Review of the Literature Themes section: This section is a bulleted list of the major themes or topics related to the research topic. Each theme or topic should have a one-two sentence summary. 1.5 ALIGNMENT: The Theoretical Foundations models and theories need to be related to and support the problem statement or study topic. The sections in the Review of the Literature are topical areas needed to understand the various aspects of the phenomenon (qualitative) or variables/groups (quantitative) being studied; to select the design needed to address the Problem Statement; to select surveys or instruments to collect information on variables/groups; to define the population and sample for the study; to describe components or factors that comprise the phenomenon; to describe key topics related to the study topic, etc. 1.5 Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format. 1 NOTE: The two parts of this section use information about the Literature Review and Theoretical Foundations/Conceptual Framework from the 10 Strategic Points. This Theoretical Foundations section is expanded upon to become the Theoretical Foundations section in Chapter 2 (Literature Review). The Theoretical Foundations and the Literature Review sections are also used to help create the Advancing Scientific Knowledge/Review of the Literature section in Chapter 2 (Literature Review). Reviewer Comments: Problem Statement It is not known what is influencing individuals' decision to not utilize mental health in the United States. It is not known how mental health providers describe the factors influencing individuals’ decision to not utilize mental health in one county located in a Southern State. While there are increasing mental health cases among the children in the county, the research topics seek to identify the key issues that prevent the people of this county from utilizing the mental health services and facilities. Population of interest are the individuals living in this Southern State region. The study plans to use qualitative-descriptive-research design in carrying out the study with target on service providers, caregivers and other mental health professionals in the county. The importance of the study is to ensure that individuals do not miss the opportunity of utilizing mental health services in the county including screening and evaluating patients and how to begin treatment if needed and the roles of primary caregivers in addressing behavioral health issues as part of the scopes of their work and those of social workers in addressing any or all issues relating to depression, anxiety and substance abuse. Criteria Learner Self-Evaluation Score (0-3) Chair or Score (0-3) Reviewer Score (0-3) Problem Statement This section includes the problem statement, the population affected, and how the study will contribute to solving the problem. The recommended length for this section is one paragraph. States the specific problem proposed for research with a clear declarative statement. Describes the population of interest affected by the problem. The general population refers to all individuals that could be affected by the study problem. Describes the unit of analysis. For qualitative studies this describes how the phenomenon will be studied. This can be individuals, group, or organization under study. For quantitative studies, the unit of analysis needs to be defined in terms of the variable structure (conceptual, operational, and measurement). Discusses the importance, scope, or opportunity for the problem and the importance of addressing the problem. The problem statement is developed based on the need or gap defined in the Background to the Study section. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuatio

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