The Planned Educational Offering

Dear Writer,
Please write one page paper addressing the highlighted questions below.
Please use 3 separate scholarly resources within 5 years to support the paper.

The DNP Project: The Planned Educational Offering
Purpose
The purpose of this discussion is to describe the planned educational offering for the DNP practice change project and how this education plan will directly impact compliance with the project intervention plan.

Instructions
Review this week’s readings and provide your response

1. State your practice question in PICOT format.
   PICOT- In adult patients with mild to moderate depression at an outpatient mental health clinic, does implementation of MBSR compared to current practice improve depression symptoms in 8-10 weeks?
2. Describe the planned educational offering for the DNP practice change project. Include the topics, the objectives, the frequency of the education sessions, and how you will evaluate learning.
   (Please discuss your education plan for your all stakeholders (participants, staff, team members, etc.)
   What is your plan for the education of the stakeholders?
   How will you implement this plan?
   How will you foster and continue enthusiasm for your intervention? )

Use Grammarly and current APA format for the post

Project outline- Resource
Evidence based intervention- According to the Centers for Disease Control and Prevention (n.d), depression is a leading cause of mental health disability in the United States, often poses a significant health burden, and is a common cause of psychiatric outpatient visits. Recommended treatment for depression includes psychotherapy and pharmacotherapy (Haller et al., 2021). The identified practice gap is that mindfulness-based interventions (MBI), such as mindfulness-based stress reduction (MBSR), are not routinely recommended as a first-line or adjunct treatment at my clinical site. At my practicum site, depressive patients tend to stop increased doses of pharmacotherapy due to the side effects and are not able to access standard psychotherapy, such as Cognitive Behavioral Therapy (CBT) due to the financial burden that tends to keep them in the continuous depressive stage. The proposed DNP project intervention aims to decrease depression symptoms in mild to moderate depressive patients in an outpatient mental health setting by implementing an eight-week mindfulness-based stress reduction intervention administered through weekly lessons and self-directed daily sessions (Hoge et al., 2023). Mindfulness-Based Stress Reduction is a feasible and emerging non-pharmacologic treatment for depression, anxiety, and stress mitigation (Chi et al., 2018; Hoge et al., 2022). The intervention helps patients cultivate self-awareness, openness, and acceptance and assists individuals in making better decisions and enhancing their capacity for coping (Chi et al., 2018). The Mindfulness-Based Stress Reduction program helps individuals reduce their stress, distress, and somatic complaints of depression and anxiety and improve psychological well-being (Norouzi et al., 2020). With the explosion of self-help applications and telehealth interventions, Mindfulness Based Stress Reduction is available as self-administered or guided meditation and reflection exercises, providing a flexible and accessible treatment method (Chi et al., 2018; Hoge et al., 2022).
PICOT- In adult patients with mild to moderate depression at an outpatient mental health clinic, does implementing Mindfulness Based Stress Reduction (MBSR) compared to current practice improve depression symptoms in 8-10 weeks?

Population, inclusion and exclusion criteria- The patients will be included in the DNP project based on age and diagnosis. The project focuses on adults 18-65 years old experiencing mild to moderate depression. A Patient Health Questionnaire (PHQ-9) score of 5-14 is the threshold for inclusion. A consent form showing the project details will be offered, including how it will benefit them and any risks involved. Those meeting the inclusion criteria must give informed consent to the project and its requirements. Those with severe depression will be excluded from the study since they likely undergo more rigorous treatment methods. Exclusion criteria for the proposed project include patients’ population with chronic depression (>2 years), mania, psychosis, and participants with physical, cognitive, and intellectual disabilities. It is expected that the project will have about 20-25 participants.

Intervention- I will, along with trained mindfulness instructors, will implement the Mindfulness Based Stress Reduction intervention to participating 18-65-year-old patients with mild to moderate depression. Sessions will occur twice weekly, with 45-minute sessions and one 8-hour weekend class on the 6th week of the implementation period. The lessons on mindfulness meditation and Mindfulness Based Stress Reduction activities will be conducted through in-person and through Zoom sessions. The recommended daily self-directed activities can be completed by participants at their own homes or other location of choice.
Week 1: Recruitment and staff training begins. I will begin reaching out to potential participants to explain the Mindfulness Based Stress Reduction program, its benefits, and the structure of the program, explain the time commitment, and obtain informed consent. Appointments will be scheduled for the in-person and virtual sessions. Staff training will occur which will include details of the project, timeline, and outline of training sessions.
Weeks 2-9: Intervention begins. I will introduce the instructors, and provide program materials to participants. A baseline assessment will be conducted using participant completed PHQ-9 surveys to assess pre- intervention data, the initial depression screening score. I and a Psychiatric Mental Health Nurse Practitioner will be available to work with participants for 45 minute sessions twice weekly. These sessions on mindfulness principles and practices will be conducted through in-person or Zoom meetings. Participants will be instructed on using the My Possible Self app for guiding daily 45-minute self-directed Mindfulness Based Stress Reduction activities and logging their daily activities. During this intervention period, formative evaluations will take place. I will solicit and provide feedback through discussions with stakeholders in weekly leadership meetings, biweekly huddles, and 1:1 weekly meeting with participants to discuss challenges, and experiences and get guidance.
Week 6: Participants will attend a virtual mindfulness workshop conducted by a me and the Psychiatric Mental Health Nurse Practitioner. Topics will include yoga, mindful walking, and meditation to enhance their practice.
Week 10: Conclusion. I will wrap up the project, administer post-intervention PHQ-9 screenings, and thank participants for being part of my DNP practice change project. One-on-one discussions with participants to assess their experience and challenges will be completed, during which time we will discuss post-intervention recourses for maintenance of mindfulness, and celebrate achievements. I plan to utilize this time to thank every participant for being part of the practice change project and for their support.
Week 11: Analysis of data will begin. Project results will be disseminated.

Data collection plan- Pre and post-test depression assessment will be done using Patient Health Questionnaire-9, a validated tool with high sensitivity, specificity, and reliability. Levis et al. (2019) found the tool has a sensitivity of 0.88 (95% CI 0.83-0.92) and a specificity of 0.85 (95% CI 0.82-0.88) in a meta-analysis of 29 studies with 6725 participants. As the project manager, I will collect self-reported data from week-to-week assessments. For data collection I will rely on weekly logs, PHQ-9 scores, and Zoom meeting observations for data collection. I will conduct the assessment process during the second phase through three steps, including data collection, data analysis, and improvement, from weeks two to nine. I will rely on weekly check-ins, attendance records in Zoom meetings and mindfulness sessions, and track their daily activities on meditation, mindfulness, and other self-care activities on the My Possible Self app and monitor for data collection during the implementation periods. Participants will log their daily Mindfulness-Based Stress Reduction activities on an online My Possible Self app. Compliance with Mindfulness-Based Stress Reduction activities will be measured on an ordinal scale with three levels: low, moderate, and high based on the average number of minutes spent in the scheduled activities.
Data Analysis- The outcome identified in the PICOT question is depression symptoms assessed through patient-reported signs and symptoms and scored using the PHQ-9. Descriptive statistics: median and range for baseline and post-test PHQ-9 scores will be calculated. Compliance with Mindfulness-Based Stress Reduction activities will be reported in the form of frequencies for the three levels. The chi-square test will be used for baseline and post-test comparisons.
Data collection process- Participant pre and post-implementation PHQ-9 scores obtained through completed survey
Translation Science Model: Knowledge-to-Action and Project Management
Theoretical Framework
The project will apply the knowledge-to-action model (KTA) developed by the National Center for Chronic Disease Prevention and Health Promotion Work Group on Translation to close the knowledge-practice gap and is also defined as translating clinical evidence, knowledge, or science to improve health outcomes (Tem Ham-Baloyi, 2022). The KTA framework has two main components: knowledge creation and action cycle. It was designed to be nonlinear, applicable in all settings, for all conditions or diseases and interventions being implemented, and to support the involvement of all stakeholders (Steinskog et al., 2021).
Knowledge Creation. This phase is divided into three aspects. The first is knowledge inquiry, which involves generating knowledge through research. The research phase involves exploring discovery, efficacy, effectiveness, and implementation studies. Discovery studies are the original epidemiological, behavioral, or biomedical findings stimulating the development of an intervention. The project idea arose after analyzing service gaps at the practicum site, noting that depression is a common cause of outpatient visits and that available treatment options are either long and costly (in the case of psychotherapy) or expensive and fraught with adverse effects (in the case of antidepressants). At the same time, MBSR has not been incorporated into the care pathways as an alternative treatment for mild to moderate depression. In this project, the research focuses on all studies exploring MBSR as an alternative treatment for mild to moderate depression, including its implementation, efficacy, and effectiveness. After inquiry, the next step involves knowledge synthesis and developing a knowledge product before deciding to translate it into practice. There must be proven efficacy of the MBSR intervention and supporting structures for effective implementation to move to the action stage. The gap in current practice is the limited use of MBSR as a routine recommendation for mild to moderate depression despite the evidence of its effectiveness.
Action Cycle. The action cycle starts with problem identification, which involves identifying a problem in practice and determining what should be in place to close that gap. The organization implements evidence-based treatment for mental disorders in current practice, but there is limited recommendation of MBSR as an alternative. The barriers are limited evidence-based understanding, time constraints, access to qualified MBSR instructors, and the patient’s preferences. The next step in the action cycle is adapting knowledge to the local context, considering the specific needs and constraints of the mental health clinic. Adapting the MBSR intervention to the specific needs of the outpatient population at the clinic, ensuring it aligns with the clinic’s resources and patient needs. Here, the project will adapt the best knowledge from the previous phase. The next step is assessing the situation to determine the barriers and facilitators of knowledge translation. Interviews, surveys, and review of records with the professionals at the clinic can be used to explore other barriers and drivers to implementation.
This step is followed by selecting, tailoring, and implementing the evidence-based intervention. MBSR is selected as the best intervention after assessing barriers and drivers for adaptation at the clinic. Some considerations include the sustainability of the intervention and the engagement of stakeholders. The intervention is to be tailored to the specific population, considering any prior treatments and the receptiveness of patients to an alternative treatment for depression. Implementation follows proper consideration of the most effective delivery strategy. The MBSR intervention will be directly administered to the patients. This is followed by monitoring knowledge use, collecting data, and evaluating its impact. Any changes are made at this point, and the cycle continues. The project will then be evaluated, and if it meets the goals, planning for sustainability follows.