Ethical Considerations

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. I am also providing my project plan, so your intervention fidelity can consistent with planned project

The DNP Project: Ethical Considerations
The purpose of this discussion is to share your plan for adherence and intervention fidelity during the project implementation. The primary emphasis of this discussion is to focus on the formative evaluation and methods of sharing this feedback to ensure the practice change project remains on track.

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. Propose your plan for intervention fidelity (compliance with your intervention implementation plan). Include how you will monitor intervention fidelity, when, and where.
3. Include your plan for relevant and timely feedback if the intervention fidelity is low. Include who will receive the feedback, when, and how.
   Use Grammarly and current APA format for the posts
   Project- intervention and data collection plan
   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, provide program materials, and demonstrate how to download the free My Possible Self app 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.
   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 utilize the My Possible Self (MPS) app and data collection tools for week-to-week assessments. My Possible Self is a well-established, validated app with a track record of showing significant improvements in depression, anxiety, and stress in users over a short period (De Kock et al., 2022). Besides the My Possible Self app, 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.