An optional dedication may be included here. While a practice improvement project is an objective, scientific document, this is the place to use the first person and to be subjective. The dedication page is numbered with a Roman numeral, but the page number does not appear in the Table of Contents. It is only included in the final practice improvement project and is not part of the proposal. If this page is not to be included, delete the heading, the body text, and the page break below. If you cannot see the page break, click on the ¶Show/Hide button (go to the Home tab and then to the Paragraph toolbar).

Acknowledgments Comment by Author: Title is bolded.

An optional acknowledgements page can be included here. This is another place to use the first person. If it applies, acknowledge and identify grants and other means of financial support. Also acknowledge supportive colleagues who rendered assistance. The acknowledgments page is numbered with a Roman numeral, but the page number does not appear in the Table of Contents. This page provides a formal opportunity to thank family, friends, and faculty members who have been helpful and supportive. The acknowledgements page is only included in the final practice improvement project, and is not part of the proposal. If this page is not to be included, delete the heading, the body text, and the page break below. If you cannot see the page break, click on the Show/Hide button (go to the Home tab and then to the Paragraph toolbar).

Table of Contents
Chapter 1: Introduction to the Project 1
Background of the Project 5
Problem Statement 6
Purpose of the Project 7
Clinical Question(s) 9
Advancing Scientific Knowledge 11
Significance of the Project 13
Rationale for Methodology 14
Nature of the Project Design 15
Definition of Terms 17
Assumptions, Limitations, Delimitations 20
Summary and Organization of the Remainder of the Project 23
Chapter 2: Literature Review 25
Theoretical Foundations 27
Review of the Literature 30
Theme 1 32
Theme 2 33
Summary 37
Chapter 3: Methodology 40
Statement of the Problem 41
Clinical Question 42
Project Methodology 44
Project Design 47
Population and Sample Selection 49
Instrumentation or Sources of Data 52
Validity 53
Reliability 54
Data Collection Procedures 55
Data Analysis Procedures 57
Potential Bias and Mitigation 59
Ethical Considerations 63
Limitations 65
Summary 66
Chapter 4: Data Analysis and Results 68
Descriptive Data 69
Data Analysis Procedures 72
Results 73
Summary 79
Chapter 5: Summary, Conclusions, and Recommendations 81
Summary of the Project 82
Summary of Findings and Conclusion 83
Implications 85
Theoretical Implications 85
Practical Implications 85
Future Implications 85
Recommendations 86
Recommendations for Future Projects 87
Recommendations for Practice 88
References 90
Appendix A 92
The Parts of a Practice Improvement Project 92
Preliminary Pages 92
Main Text 92
Supplementary Pages 93
Appendix B 94
What is my DPI project design? 94
Appendix C 96
Power Analysis Using G Power 96
Appendix D 97
Example SPSS Dataset & Variable View 97
Appendix E 98
How to Make APA Format Tables and Figures Using Microsoft Word 98
Appendix F 108
Writing up your statistical results 108

The List of Tables follow the Table of Contents.

The List of Tables is NOT included in the Table of Contents. The title is bolded and centered.

(Note: single-space table titles; use “Add a Space After Paragraph” (12pt) in Line Spacing Options between table titles)

The List of Figures follows the List of Tables.

The List of Figures is NOT included in the Table of Contents. 1 in. margin on each page. The title is bolded.

Figures include graphs, charts, maps, drawings, cartoons, and photographs. In the List of Figures, single-space figure titles and double-space between entries. See 7th APA Canual Chapter 7 for details and specifics on Figures and Data Display.

(Note: single-space figure titles; use “Add a Space After Paragraph” (12pt) in Line Spacing Options between table titles) double-space between entries)

The Introduction section of Chapter 1 briefly overviews the project focus or practice problem, states why the project is worth conducting, and describes how the project will be completed. The introduction develops the significance of the project by describing how the project translates existing knowledge into practice (current orignianl quantitative research or clinical practice guidelines that were never used at the site prior within five years of your graduation date), is new or different from other works and how it will benefit patients at your clinical site. This section should also briefly describe the basic nature of the project and provide an overview of the contents of Chapter 1. This section should be three or four paragraphs, or approximately one page, in length.

Keep in mind that you will write Chapters 1 through 3 as your direct practice improvement (DPI) project proposal and Chapters 1 through 5 for your final project manuscript. (see Appendix A) However, there are changes that typically need to be made in these chapters to enrich the content or to improve the readability as you write the final DPI project manuscript. Often, after data analysis is complete, the first three chapters will need revisions to reflect a more in-depth understanding of the topic, change the tense to past tense, and ensure consistency.

To ensure the quality of both your proposal and your final practice improvement project and reduce the time for Academic Quality Review (AQR) reviews, your writing needs to reflect standards of scholarly writing
from your very first draft. Each section within the proposal or final DPI project should be well organized and presented in a way that makes it easy for the reader to follow your logic. Each paragraph should be short, clear, and focused. A paragraph should (a) be three to eight sentences in length, (b) focus on one point, topic, or argument, (c) include a topic sentence the defines the focus for the paragraph, and (d) include a transition sentence to the next paragraph. Include one space after each period. There should be no grammatical, punctuation, sentence structure, or American Psychological Association APA formatting errors. Be sure to use the
check document feature in the Microsoft Word Review Menu. This feature will check for spelling errors and grammatical issues.

Verb tense is an important consideration for Chapters 1 through 3 versus the final manuscript. For the proposal, the investigator uses present tense (e.g., “The purpose of this project is to…”), whereas in the practice improvement final project, the chapters are revised into past tense (e.g., “The purpose of this project was to…”). Taking the time to put quality into each draft will save you time in all the steps of the development and review phases of the practice improvement project process. It will pay to do it right the first time. Comment by Author: Consider where you are in the process when determining past or present tense. If your project has been implemented, and you have finished your data collection, then the entire manuscript should be written in past tense.

· 3 = The criterion has been completely met. It is comprehensive and accurate. The section meeting the criterion is comprehensive and clear. The criterion information is very well written. The section addressing a criterion is located in a single spot; it is not distributed across various paragraphs. The criterion is immediately obvious to an external reviewer. In terms of writing, the section is perfect and ready to go into a journal article.

· 2 = The criterion is very close to being completely met. The section meeting the criterion is comprehensive but may need to be further clarified. The criterion information is fairly well written but may need minor editing. The section addressing a criterion is located in a single spot; it is not distributed across various paragraphs. It may not be obvious to an external reader and so may require some clarification. In terms of writing it is near perfect but may need minor edits for clarity or APA formatting.

· 1 = The criterion is present, but the section needs significant work to completely meet expectations. The section meeting the criterion is not comprehensive and may need to be further clarified. The criterion information is fairly well written but may need minor editing. The section addressing a criterion is not clearly located in a single spot; it appears to be distributed across various paragraphs. It may not be obvious to an external reader and requires some clarification. It needs some changes to the structure, flow, paragraph structure, sentence structure, punctuation, and APA format.

· 0 = The criterion is not addressed because it is missing or is not appropriate.

Once the document has been approved by your chairperson and your committee and is ready to submit for the AQR review, please remove all of these assessment tables from this document.

The background section of Chapter 1 explains both the history of and the present state of the problem and the DPI project focus. This section summarizes the Background section which will be expanded upon in Chapter 2 and is two or three paragraphs in length.

This section of the final manuscript is two or three paragraphs long. It clearly states the problem or project focus, the population affected, and how the project will contribute to solving the problem. This section of Chapter 1 should be comprehensive yet simple, providing context for the practice project.

This section should be two or three paragraphs in length, narrow the focus of the project, and specify the clinical questions to address the problem statement. Based on the clinical questions, the section describes the variables or groups. The clinical questions should be derived from, and are directly aligned with, the problem and purpose statements, methods, and data analyses. The Clinical Questions section of Chapter 1 will be presented again in Chapter 3 to provide clear continuity for the reader and to help frame your data analysis in Chapter 4.

In a paragraph prior to listing the clinical questions, include a discussion of the clinical questions, relating them to the problem statement. Templated statement: To what degree does the implementation of _______________ (intervention) impact(s) __________________ (what) when compared to _____________ among _____________ (population) patients in a ______ (setting) in _______ (state)? Comment by Author: Format your clinical question in this manner.

Then, include a leading phrase to introduce the questions such as: The following clinical questions guide this quantitative project: Comment by Author: DO NOT have more than two questions! Every question you have, you have to measure and report in the abstract. Stick to one or two measurable PATIENT outcomes.
If you aim to identify something you have to address what you would do. So if you identify dental infections you need refer them to a dentist, if you identify depression you have to do something about it.

The Advancing Scientific Knowledge section should be two or three paragraphs in length, and specifically describe how the project will advance population health outcomes on the topic. This advancement can be a small step forward in a line of the current clinical site practice, but it must add to the current body of knowledge in the literature. This section also identifies the
gap or
need based on the current literature and discusses how the project will address that gap or need. This section summarizes the Theoretical Foundations section from Chapter 2 by identifying the theory or model upon which the project is built. It also describes how the project will advance that theory or model.

This section identifies and describes the significance of the project. It also discusses the implications of the potential results based on the clinical questions and problem statement. Further, it describes how the project fits within and will contribute to the current literature or the clinical site practice. Finally, it describes the potential practical applications from the project. This section should be three or four paragraphs long and is of particular importance because it justifies the need for, and the relevance of, the project.

This section introduces the methodology for the DPI project and explains the rationale for selecting this quantitative methodology. The Rationale for Methodology section of Chapter 1 clearly justifies the methodology the investigator plans to use for conducting the project. It argues how the methodological framework is the best approach to answer the clinical questions and address the problem statement. Finally, it contains citations from textbooks and articles on the DPI project methodology or articles on related studies (Creswell & Creswell, 2018). DPI project are typically quantitative due to the nature of measuring a practice improvement.

This section describes the clinical questions the project will answer and identifies the variables using the format appropriate for the specific design. Finally, this section includes a discussion of the clinical questions, relating them to the problem statement. This section should be two or three paragraphs long and illustrate how the methodological framework is aligned with the problem statement and purpose of the project, providing additional context for the project.

This section describes the specific project design
(quasi-experimental) to answer the clinical questions and why this approach was selected. (see Appendix B) Here, the learner discusses why the selected design is the best design to address the problem statement and clinical questions as compared to other designs. You should be focusing on the design rather than the methodology in this section. Briefly describes how the design supports the intervention and solution to the practice problem. This section also contains a description of the project sample being investigated, as well as the process that will be used to collect the data on the sample. In other words, this section provides a preview of Chapter 3 and succinctly conveys the project approach to answer clinical questions.

The Definition of Terms section of Chapter 1 defines the project constructs and provides a common understanding of the technical terms, exclusive jargon, variables, phenomena, concepts, and sundry terminology used within the scope of the project. Terms are defined in lay terms and in the context in which they are used within the project. Each definition may be a few sentences to a paragraph in length. This section includes any words that may be unknown to a lay person (words with unusual or ambiguous meanings or technical terms) from the evidence or literature. It provides a rationale for each assumption and defines the variables.

Definitions must be supported with citations from scholarly sources. Do not use Wikipedia to define terms. This popular “open source” online encyclopedia can be helpful and interesting for the layperson, but it is not appropriate for formal academic scholarly writing. Additionally, do not use dictionaries to define terms. A paragraph introducing this section prior to listing the definition of terms can be inserted. However, a lead in phrase is needed to introduce the terms such as: “The following terms were used operationally in this project.” This is also a good place to operationally define unique phrases specific to this project. See below for the correct format:

Term.

Comment by Author: This is how each of your terms should be listed in this section.

Write the definition of the word. This is considered a
Level 3 heading. Make sure the definition is properly cited (Author, 2010).

Clinical Significance.

Clinical significance (also known as clinical relevance) indicates whether the results of a project are meaningful or not for several stakeholders.
Statistical significance does not assure that the results are clinically relevant. Indeed, the use of significance testing rarely determines the practical importance or clinical relevance of findings (Armijo-Olivo, 2018)

Comparison and Intervention Group.

Refers to the sample groups of data in your project as the comparison group and the intervention group. These groups can be used to compare the baseline practice to the direct practice improvement. There are two approaches to the data of these groups. 
Between–
group differences show how two or more
groups of the data are sampled or participants are different, whereas 
within–
group differences show differences among data or participants who are in the same single
group of the sample (Creswell & Creswell, 2018). Further, w
ithin–
group differences can come to light when looking at the results of a 
between–
groups approach including individual differences associated with the sample or group. (see Figure 1). Please note that there are
no control groups in the DPI. If the learner writes control groups as a comparison group, the DPI will not move forward.

Statistical Significance.

Statistical significance shows a result is unlikely due to chance. It is a result which indicates a level of confidence a result did not occur solely from sample selection. The investigator determines the level of significance for the project (e.g.
p<.05 or p<.01
). The
p-value is the probability of obtaining the difference measured from a sample if there really is not a difference for all users. If the
p-value obtained is less than this level determined in the proposal by the investigator, it would be considered statistically significant. The investigator would infer the intervention caused the difference.
Statistical significance is not
clinical significance or whether the results of a project are meaningful or not for several stakeholders (Creswell & Creswell, 2018).

Terms often use abbreviations. According to APA (2010), abbreviations are best used only when they allow for clear communication with the audience. Standard abbreviations, such as units of measurement and names of states, do not need to be written out.

Only certain units of time should be abbreviated. Abbreviate hr. (hour), min (minute), ms (millisecond), ns (nanosecond), or s (second). However, do not abbreviate day, week, month, and year [4.27]. To form the plural of abbreviations, add “s” alone without apostrophe or italicization (e.g., vols., IQs, Eds.). The exception to this rule is not to add “s” to pluralize units of measurement (12 m not 12 ms) [4.29].

This section identifies the assumptions and specifies the limitations, as well as the delimitations, of the project. It should be four to six paragraphs in length.

An assumption is a self-evident truth. Assumptions are things that are accepted as true, or at least plausible, by other researchers, peers, and generally to most people will read your project. In other words, any scholar reading your paper will assume that certain aspects of your project are true given your population, statistical test, project design, or other delimitations. For example, if you tell your friend that your favorite restaurant is an Italian place, your friend will assume that you don’t go there for the sushi. It’s assumed that you go there to eat Italian food. Because most assumptions are not discussed in-text, assumptions that are discussed in-text are discussed in the context of the limitations of your project, which is typically in the discussion section. This is important, because both assumptions and limitations affect the inferences you can draw from your project.

This section should list what is assumed to be true about the information gathered in the project. State the assumptions being accepted for the project as methodological, theoretical, or topic specific. For each assumption listed, you must also provide an explanation. Provide a rationale for each assumption, incorporating multiple perspectives, when appropriate. For example, the following assumptions were present in this project:

1. It is assumed that survey participants in this project were not deceptive with their answers, and that the participants answered questions honestly and to the best of their ability. Provide an explanation to support this assumption.

2. It is assumed that this project is an accurate representation of the current situation in rural southern Arizona. Provide an explanation to support this assumption. Limitations are things that the investigator has no control over, such as bias.

It is important to remember that your limitations and assumptions should not contradict one another. Assumptions are also present with the statistical tests performed in the DPI. These assumptions refer to the characteristics of the data, such as distributions, trends, and variable type, just to name a few. Violating these assumptions can lead to drastically invalid results, though this often depends on sample size and other considerations.

Limitations are a systematic bias that you did not or could not control which could inappropriately affect the results. Delimitation is a systematic bias intentionally introduced into the project or instrument by you. Possible limitations and delimitations in the project design or impact and statistical or data limitations: For example, sample choice and size of the sample, the availability and reliability of data , access to protected or proprietary data, methods/instruments/techniques used to collect the data, the use of self‐reported data, time constraints or cultural and other communication issues.

Delimitations are things over which the investigator has control, such as location of the project, population and sample, and data collection tools like the electronic health record (EHR).

Identify the limitations and delimitations of the project design. Discuss the potential generalizability of the project findings based on these limitations. For each limitation and delimitation listed, make sure to provide an associated explanation. For example: The following limitations/delimitations were present in this project:

1. Lack of funding limited the scope of this project. Provide an explanation to support this limitation.

2. The survey of high school students was delimited to only rural schools in one county within southern Arizona, limiting the demographic sample. Provide an explanation to support this delimitation.

Identify the limitations of your project and explain the importance of each. Reflect on the nature of the limitations and justify the choices made during the project. Advance the evidence by suggesting how such limitations could be overcome in future.

This section summarizes the key points of Chapter 1 and provides supporting citations for those key points. It then provides a transition discussion to Chapter 2 followed by a description of the remaining chapters. For example, Chapter 2 will present a review of current evidence on the centrality of the practice improvement project literature review and the existing evidence available to guide project preparation. Chapter 3 will describe the methodology, design, and procedures for this investigation. Chapter 4 details how the data was analyzed and provides both a written and graphic summary of the results. Chapter 5 is an interpretation and discussion of the results, as they relate to the existing body of evidence related to the practice improvement project topic.

This chapter presents the theoretical framework for the project and develops the topic, specific practice problem, question(s), and design elements. In order to perform significant practice improvement projects, the learners must first understand the literature related to the project focus. A well-articulated, thorough literature review provides the foundation for substantial, contributory projects or evidence. The purpose of Chapter 2 is to develop a well-documented argument for the selection of the project topic, formulate the clinical questions, and justify the choice of methodology as introduced in Chapter 1. A literature review is a
synthesis of what has been published on a topic by accredited scholars and investigators. It is not an expanded annotated bibliography or a summary of peer reviewed articles related to your topic.

The literature review will place the project focus into context by analyzing and discussing the existing body of knowledge and effectively presenting the reader with an exhaustive review of known information. The comprehensive presentation should include as much information as possible pertaining to what has been discovered in the evidence about that focus, and where the gaps and tensions in the evidence exist. As a piece of writing, the literature review must convey to the reader what knowledge and ideas have been established on a topic and build an argument in support of the practice problem.

This section describes the overall topic to be investigated, outlines the approach taken for the literature review, and defines the evolution of the problem based on the evidence to cover the
gap or
need to improve population health outcomes. Make sure the Introduction and Background section of your literature review addresses the following required components:

· Introduction: States the overall purpose of the project.

· Introduction: Provides an orienting paragraph so the reader knows what the literature review will address.

· Introduction: Describes how the chapter will be organized (including the specific sections and subsections).

· Introduction: Describes how the literature was surveyed, so the reader can evaluate the thoroughness of the review.

· Background: Provides a historical overview of the problem based on the gap or need defined in the literature and how it originated. This section must contain empirical (original research) citations. Present strong evidence for the intervention.

· Background: Discusses how the problem has evolved historically into its current form.

This section identifies the nursing theories and evidence-based practice change models that provide the foundation for the Direct Practice Improvement (DPI) Project. It also contains an explanation of how the problem under investigation relates to the nursing theories and evidence-based practice change models. The seminal source for each nursing theory and evidence-based change model should be identified and described. Please note: models and theories are not capitalized in APA style.

The theories or models(s) guide the clinical questions and justify what is being measured (variables), as well as how those variables are related. This section also must include a discussion of
how the clinical question(s) align with the a nursing theory or nursing model and illustrates how the project fits within other evidence, based on the theories or models.
You are encouraged to use a change model to outline how the DPI project would be implemented in a healthcare organization. Please outline and define the change model steps or processes and how those steps are implemented for the DPI project. The learner should cite references reflective of the foundational, historical, and current literature in the field. Overall, the presentation should reflect that the learner understands the theory or model and its relevance to the project. The discussion should also reflect knowledge and familiarity with the historical development of the theories or models.

This section provides a broad, balanced overview of the existing literature related to the topic. It identifies themes, trends, and conflicts in methodology, design, and findings. It provides a synthesis of the existing literature, examines the contributions of the literature related to the topic, and presents an evaluation of the overall methodological strengths and weaknesses of the evidence. Through this synthesis, the gaps in evidence should become evident to the reader.

This section describes the literature in related topic areas and its relevance to the project topic. It provides an overall analysis of the existing literature examining the contributions of this literature to the field, identifying the conflicts, and relating the themes and results to the project. Citations are provided for all ideas, concepts, and perspectives. The investigator’s personal opinions or perspectives are not included.

The required components for this section include the following:

· Chapter 2 needs to be at least 20-25 pages in length. It needs to include a minimum of 50 scholarly sources with 85% of sources published within the past 5 years. Additional sources do not necessarily need to be from the past 5 years.

· Quantitative project: Describes each project variable in the project and discusses the prior evidence that has been done on the variable. Comment by Author: Please note that you may also use seminal works and other relevant literature that supports your topic concept. However you are REQUIRED to have ORIGINAL research to support your intervention and that ORIGINAL RESEARCH must come from the USA first or Canada if you are a Canadian student. Then you can use others.

· Discusses the various methodologies and designs that have been used to provide evidence on topics related to the project. Uses this information to justify the design.

· Relates the literature back to the DPI-project topic and the practice problem.

· Argues the appropriateness of the practice improvement project’s instruments, measures, or approaches used to collect data.

· Discusses topics related to the practice improvement project topic. This section may include (a) studies relating the variables (quantitative); (b) studies on related evidence-based research, such as factors associated with the topic; (c) studies on the instruments used to collect data; and (d) studies on the broad population for the project.

· Set of topics discussed in the Review of Literature demonstrates a comprehensive understanding of the broad area in which the project topic exists.

· Argues the appropriateness of the practice improvement project’s instruments, measures, or approaches used to collect data.

· Each section within the Review of Literature includes an introductory paragraph that explains why the particular topic was explored relative to the practice improvement project topic.

· Each section also requires a summary paragraph(s) that (a) compares and contrasts alternative perspectives on the topic, (b) provides a summary of the themes relative to the topic discussed that emerged from the literature, (c) discusses data from the various studies, and (d) identifies how themes are relevant to your practice improvement project topic.

· The types of references that may be used in the literature review include empirical (original research) articles
(MUST HAVE) evidence-based research, meta-analysis, systematic reviews, randomized control trials, or seminal works, peer-reviewed or scholarly journal articles, and books that are cutting-edge views on a topic.

The body of a literature review can be organized in a variety of ways depending on the nature of the project. Work with your committee chairperson to determine the best way to organize this section of Chapter 2, as it pertains to your overall project design. This template organizes the evidence thematically as illustrated below.

You may want to organize this section by themes and subthemes. To do so, use the pattern below.

Grouped findings related to Theme 1.

Subtheme
2. Comment by Author: This heading is tagged with APA Style Level 4 heading [3.03].

To differentiate the Level 4 heading from the normal style of the text, write the Level 4 heading and tag it.

Then, create the first paragraph of the subsection on the line below the theme heading.

Then, place the cursor next to the theme heading. Hit the keys “cntrl + alt + enter.” This will create a “style break” so that the Level 4 heading and the normal paragraph do not connect but are formatted correctly on the same line.

Grouped findings related to Theme 1.

Subtheme
3. Comment by Author: This heading is tagged with APA Style Level 4 heading [3.03].

To differentiate the Level 4 heading from the normal style of the text, write the Level 4 heading and tag it.

Then, create the first paragraph of the subsection on the line below the theme heading.

Then, place the cursor next to the theme heading. Hit the keys “cntrl + alt + enter.” This will create a “style break” so that the Level 4 heading and the normal paragraph do not connect but are formatted correctly on the same line.

Grouped findings related to Theme 1.

Please follow the same Theme-subtheme process as outlined above.

Subtheme
1. Comment by Author: This heading is tagged with APA Style Level 4 heading [3.03].

To differentiate the Level 4 heading from the normal style of the text, write the Level 4 heading and tag it.

Then, create the first paragraph of the subsection on the line below the theme heading.

Then, place the cursor next to the theme heading. Hit the keys “cntrl + alt + enter.” This will create a “style break” so that the Level 4 heading and the normal paragraph do not connect but are formatted correctly on the same line.

Grouped findings related to Theme 2.

Subtheme
2. Comment by Author: This heading is tagged with APA Style Level 4 heading [3.03].

To differentiate the Level 4 heading from the normal style of the text, write the Level 4 heading and tag it.

Then, create the first paragraph of the subsection on the line below the theme heading.

Then, place the cursor next to the theme heading. Hit the keys “cntrl + alt + enter.” This will create a “style break” so that the Level 4 heading and the normal paragraph do not connect but are formatted correctly on the same line.

Grouped findings related to Theme 2.

Subtheme
3. Comment by Author: This heading is tagged with APA Style Level 4 heading [3.03].

To differentiate the Level 4 heading from the normal style of the text, write the Level 4 heading and tag it.

Then, create the first paragraph of the subsection on the line below the theme heading.

Then, place the cursor next to the theme heading. Hit the keys “cntrl + alt + enter.” This will create a “style break” so that the Level 4 heading and the normal paragraph do not connect but are formatted correctly on the same line.

Grouped findings related to Theme 2.

In a concluding paragraph, provide a synthesis of the evidence studies presented in Theme 2. Discuss the strengths and weaknesses of each project, as well as the variables, instrumentation, and findings of each project as they relate to each other and use the findings of the studies in the subtheme to build an argument for your project. Discuss what is missing or how the design or methodology could have changed in studies to improve the quality of the project. Discuss inconsistencies or gaps that emerge in the evidence providing opportunity for additional projects. Provide a transition sentence to the next theme.
Need at least three themes.

Chapter 2 can be particularly challenging with regard to APA format for citations and quotations. Refer to your APA manual frequently to make sure your citations are formatted properly. It is critical that each in-text citation is appropriately listed in the References section.

For a quote within a quote, use a set of single quotation marks. [4.08]. As a rule, if a quote comprises 40 or more words, display this material as a freestanding block quote. Start formal block quotes on a new line. They are indented one inch in from the left margin. The entire block quote is double-spaced. Quotation marks are
not used with formal block quotes. The in-text citation is included after the final punctuation mark. [6.03]. Below is an example of a block quote: In an important biography,
The First American: The Life and Times of Benjamin Franklin, historian H. W. Brands writes: Comment by Author: Caution! Make sure you do not overuse titles in the literature review. You can use them in certain instances, but do not rely on them to convey content.

In February 1731, Franklin became a Freemason. Shortly thereafter, he volunteered to draft the bylaws for the embryonic local chapter, named for St. John the Baptist; upon acceptance of the bylaws, he was elected Warden and subsequently Master of the Lodge. Within three years, he became Grandmaster of all of Pennsylvania’s Masons. Not unforeseeable he—indeed, this was much of the purpose of membership for everyone involved—his fellow Masons sent business Franklin’s way. In 1734 he printed
The
Constitutions, the first formerly sponsored Masonic book in America; he derived additional [printing] work from his brethren on an unsponsored basis. (Brands, 2000, p. 113)

This section restates what was written in Chapter 2 and provides supporting citations for key points. It synthesizes the information from the chapter using it to define the “gaps” in or “project needs” from the literature, the theories or models to provide the foundation for the project, the problem statement, the primary clinical question, the methodology, the design, the variables or phenomena, the data collection instruments or sources, and population. It then provides a transition discussion to Chapter 3.

Overall, this section should:

· Synthesize the information from all of the prior sections in the literature review and use it to define the key strategic points for the project.

· Summarize the gaps and needs in the background and introduction and describe how it informs the problem statement.

· Identify the theories or models describing how they inform the clinical questions.

· Use the literature to justify the design, variables, data collection instruments or sources, and population to be evaluated.

· Relates the literature back to the DPI-project topic and the practice problem.

· Build a case (argument) for the project in terms of the value of the project and how the clinical questions emerged from the review of literature.

· Explain how the current theories, models, and topics related to the project will be advanced through your project.

· Summarize key points in Chapter 2 and transition into Chapter 3.

This section should help the reader clearly see and understand the relevance and importance of the project to be conducted. The Summary section transitions to Chapter 3 by building a case for the project, in terms of project design and rigor, and it formulates the clinical questions based on the gaps and tensions in the literature. Comment by Author: Use INSERTPage Break to set new page for new chapter. Do not use hard returns to get there.

Chapter 3 documents how the project is conducted in enough detail so that replication by others is possible. The introduction begins with a summary of the project focus and purpose statement to reintroduce the reader to the need for the project. This can be summarized in three or four sentences from Chapter 1. Summarize the clinical questions in narrative format, and then outline the expectations for this chapter.

Remember, throughout this chapter depending on where you are in your project, the verb tense must be changed from present tense (proposal) to past tense (DPI Project manuscript). Furthermore, consider will happen during data collection and analysis as it is planned here. Sometimes, the DPI project protocol ends up being modified based on committee, Academic Quality Review (AQR), or Institutional Review Board (IRB) recommendations. After the practice project is complete, make sure this chapter reflects how the project was
actually conducted.

This section restates the problem for the convenience of the reader. Copy and paste the Statement of the Problem from Chapter 1. Then, edit, blend, and integrate this material into the narrative. Change future tense to past tense for DPI Project manuscripts.

This section restates the clinical question(s) for the project from Chapter 1. The following clinical questions guide this quantitative project:

It then presents the matching of the variables. This discussion includes the independent variable (intervention or practice change) and the dependent variable (outcome of the DPI) (see Table 1)

Note: An outcome variable can be any of the four levels of measurement. (Creswell & Creswell, 2018).

The section also briefly reviews the approaches to collecting the data to answer the clinical questions (see Figure 1).

Approaches to Collecting the Data to Answer the Clinical Questions

Between-subjects (or between-groups) designs include different people or data in each collection so that each person is only in one group or the other. Within-subjects (or repeated-measures) design include the same person in all collections both before and after the intervention.

The section should describe the instrument(s) or data source(s) to collect the data for each variable. It also discusses why the design was selected to be the best approach to answer the clinical question(s).

This section describes the methodology for the DPI project and explains the rationale for selecting this quantitative methodology. It also describes why this methodology was selected as opposed to the alternative methodologies. (see Table 2) DPI projects are typically quantitative due to the nature of measuring a practice improvement.

Type of Methodology and Rationale for Selecting It

Note: Quantitative methods are recommended for DPI projects due to feasibility and clinical relevance associated with the measurement of a practice improvement. Reference: Creswell, J.W. & Creswell, J.D. (2018
).
Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.) Thousand Oaks: CA. Sage Publications.

This section should elaborate on the Methodology section (from Chapter 1) providing the rationale for the selected project method (e.g. quantitative). Arguments are supported by citations from articles and books on methodology or design. It is also proper in this section to outline the predicted or expected results in relation to the clinical questions based on the existing literature. Describe how the method selected supports the attainment of information that will answer the clinical questions.

This section elaborates on the nature of the Project Design section from Chapter 1. In most DPI projects, a quasi-experimental design is the recommended due to measurement of a direct practice improvement. If other methods are considered, it should be discussed with your chair/committee including the capacity to measure a practice improvement and time frame needed to complete it.

This section includes a detailed description of, and a rationale for, the specific design for the project. Quantitative designs include descriptive, correlation, quasi-experimental, and experimental designs (Creswell & Creswell, 2018). Each associated with an approach to the data being collected. See Appendix B for an algorithm to assist with design determination. Designs involving a practice change or intervention are either a
quasi-experimental or
experimental type. However, an experimental design is usually not feasible for a DPI (The DPI is quasi-experimental, quality Improvement) due to the requirement for randomization and manipulation of the intervention within and between the project groups to address the statistical assumptions.

This section further describes how it aligns to the selected methodology indicated in the previous section. Additionally, it describes why the selected design is the best option to collect the data to answer the clinical need for the project.

The section explains exactly how the selected design will be used to collect data for each variable. It identifies the specific instruments and data sources to be used to collect all of the different data required for the project. Arguments are supported by citations from articles and books on DPI project method or design. This section should specify the independent, dependent, or classificatory variables, as appropriate. These variables should be defined in Chapter 1. Be sure to relate the variables back to the clinical questions. A brief discussion of the type of data collection tool chosen (survey, interview, observation, etc.) can also be included in this section as related to the variables. Collecting data using an instrument may require a consent versus collecting data from the EHR may require a HIPAA waiver. These considerations should be addressed later in the proposal.

This section discusses the setting, total population, project population, and project sample. The discussion of the sample includes the project terminology specific to the type of sampling for the project. This section should include the following components:

· Describes the characteristics of the total population and the project population from which the project sample (project participants) is drawn.

· Describes the characteristics of the project population and the project sample.

· Clearly defines and differentiates the sample for the project versus the number of people completing instruments on the project sample.

· Describes the project population size and project sample size and justifies the project sample size (e.g., power analysis) based on the selected design.

Clearly defines and differentiates between the number for the project population and the project sample versus the number for the people who will complete any instruments. Details the sampling procedure including the specific steps taken to identify, contact, and recruit potential project sample participants from the project population.

Describes the informed consent process, confidentiality measures, project participation requirements, and geographic specifics.

· Discusses the intervention protocol to answer the clinical question(s).

· If subjects withdrew or were excluded from the project, you must provide an explanation. This would be added for the final manuscript and would not be present in the proposal.

This section fully identifies and describes the types of data that will be collected, as well as the specific instruments and sources used to collect those data (tests, questionnaires, interviews, databases, media, etc.). Discuss the specific instrument or source to collect data for each variable or group. Use subheadings for each data collection instrument or source of data and provide a copy of all instruments in a separate appendix.

If you are using an existing instrument, make sure to discuss in detail the characteristics of the instrument. For example, on a preexisting survey tool describe the way the instrument was developed and constructed, the validity and reliability of the instrument, the number of items or questions included in the survey, and the calculation of the score as appropriate.

If you are using a source of data, discuss the detail on how the source of data was accessed, the validity and reliability of the source of data and how the information was collected and stored. If the learner is acquiring data from medical records or databases, e.g. electronic health records including being provided a delimited database of data, this access and permission should be specified and how the identifiable patient information is being protected within the project. A HIPAA waiver may be specified.

This section describes and defends the procedures used to determine the validity of the data collected. Validity refers to the degree to which a project accurately reflects or assesses the specific concept that the investigator is attempting to measure. Ask if what is actually being measured is what was set out to be measured. As an investigator, you must be concerned with both external and internal validity.

For this section, provide specific validity statistics found in the literature for quantitative instruments, identifying how they were developed. NOTE: Learners should not be developing any quantitative instruments without permission from the DNP department.

This section describes and defends the procedures used to determine the reliability of the data collected. Reliability is the extent to which an experiment, test, or any measuring procedure is replicable and yields the same result with repeated trials. For this section, provide specific reliability statistics for quantitative instruments, identifying how the statistics were developed from the literature.

This section details the entirety of the process used to collect the data. Describe the step-by-step procedures used to carry out all the major steps for data collection for the project in a way that would allow another investigator to replicate the project. The key elements of this section include:

· A description of the procedures for project sample recruitment, sample selection, and assignment to groups (e.g. comparison versus intervention).

· A description of the procedures for obtaining informed consent and for protecting the rights and well-being of the project sample participants, as well as those completing instruments on them.

· A description of the procedures adopted to maintain data securely, including the length of time data will be retained, where the data will be retained, and how the data will be destroyed.

· A description of the procedures for data collection, including how each instrument or data source was used, how and where data were collected, and how data were recorded.

· An explanation of the independent and dependent variables (if applicable), and how the resulting change in those variables is measured (if applicable),

· An explanation of how variables were compared (if applicable).

This section provides a step-by-step description of the procedures to be used to conduct the data analysis. The key elements of this section include:

· A description of how the data were collected and organized for each variable or group.

· A description of the type of data to be analyzed, identifying the descriptive, inferential, or nonstatistical analyses.

· Demonstration that the project analysis is aligned to the specific project design.

· A description of the clinical question(s).

· A detailed description of the relevant data collected and analyzed for each stated clinical question.

· A description of how the raw data were organized and prepared for analysis. Provides a step-by-step description of the procedures used to conduct the data analysis.

Parametric Statistics for Analysis of Ratio or Interval Level Dependent Variable

Note. Image taken from Creswell and Creswell (2018). Comment by Author: Remove these figures from your manuscript. See APA 7th edition to format tables and figures.

The independent variable within a quasi-experimental design will be a nominal or categorical level variable identifying the sample or group associated with the intervention. It is the dependent variable’s level of measurement which will direct the type of statistical analysis e.g. parametric versus non-parametric. If the dependent variable is a ratio, interval, the test to be used would be a parametric one. If the dependent variable is an ordinal or nominal level, a non-parametric test would be used.

Figure 3

Non-Parametric Statistics for Analysis of Nominal or Ordinal Level Dependent Variable

Be specific on the type of analysis being performed, the type of variables analyzed, the level of measurement, and the statistical test performed to answer the clinical question.

Bias in sampling can occur. A sampling method is called biased if it systematically favors some outcomes over others. The following example shows how a sample can be biased, even though there is some randomness in the selection of the sample.

Example:

If my project employs an intranet survey and there are people who meet the criteria but do not have access to the internet to take the survey, I will miss all those people who met the criteria for participation!

Here are some common sources and consequences of bias:

Convenience samples:

Sometimes it is not possible or not practical to choose a random sample. In those cases, a convenience sample might be used. Sometimes it is plausible that a convenience sample could be considered as a random sample, but often a convenience sample is biased.
If a convenience sample is used, inferences are not as trustworthy as if a random sample is used.

Bias may be present in data collection. While collecting data for the DPI, there are numerous ways by which the Learners may introduce bias to the project. If, for example, during patient recruitment, some patients are less or more likely to participate in the project such sample would not be representative of the population in which

this project is done (Roush, 2020). In that case, these subjects who are less likely to enter the study will be underrepresented and those who are more likely to enter the study will be over-represented relative to others in the general population, to which conclusions of the study are to be applied to (Roush, 2020). This is what we call a selection bias. To ensure that a sample is representative of a population, sampling should be random, i.e. every subject needs to have equal probability to be included in the DPI. It should be noted that sampling bias can also occur if sample is too small to represent the target population. For example, if the aim of the DPI is to assess the if motivational interviewing in psychiatric patients improves medication adherence the Learners may only be able to recruit otherwise healthy, stable patients during a regularly scheduled well check-up. By recruiting only well patients and the inability to use all psychiatric clients that can consent this is another bias.

Bias can also occur in the data analysis right? We often are only looking at data that gives preference to answering the clinical question. If the data is misrepresented or not fully reported or even manipulated this is a bias (Fox & Lash, 2020). Comment by Author: Make sure all citations are entered in the reference list as the reviewers will check all citations and references for accuracy.

Bias may occur in the data interpretation. It is imperative to run the correct statistical analysis (Fox & Lash, 2020). The data must be correctly analyzed and presented as is. Do not report only what was significant or discuss what was not significant. Consider a project where your pre and post-knowledge test for nurses did not show a statistical significance in using the tool. However, if the tool decreased readmission rates by 50% was it clinically significant? This observation should be discussed in detail.

This section discusses the potential ethical issues surrounding the project, as well as how human subjects and data will be protected. The key ethical issues that must be addressed in this section include:

· Identify how any potential ethical issues will be addressed.

· Provide a discussion of ethical issues related to the project and the sample population of interest, institution, or data collection process.

· Address anonymity, confidentiality, privacy, lack of coercion, informed consent, and potential conflict of interest.

· Demonstrate adherence to the key principles of the Belmont Report (respect, justice, and beneficence) in the project design, sampling procedures, and within the theoretical framework, practice or patient problem, and clinical questions.

· Discuss how the data will be stored, safeguarded, and destroyed.

· Discuss how the results of the project will be published.

· Discuss any potential conflict of interest on the part of the investigator.

· Reference IRB approval to conduct the project, which includes subject recruiting and informed consent processes, in regard to the voluntary nature of project.

· Include the IRB approval letter with the protocol number, informed consent/subject assent documents, or any other measures required to protect the participants or institutions in an appendix.

While Chapter 1 addresses the broad, overall limitations of the project, this section discusses in detail the limitations related to the DPI project approach and methodology and the potential impacts on the results. This section describes any limitations related to the methods, sample, instrumentation, data collection process, and analysis. Other methodological limitations of the project may include issues with regard to the sample in terms of size, population and procedure, instrumentation, data collection processes, and data analysis. This section also contains an explanation of why the existing limitations are unavoidable and are not expected to affect the results negatively.

Here you need to consider potential limitations and delimitations, which could impact your proposed project’s implementation. Are the nursing staff resistant to change? Is there currently a culture inherent in the site where the use of evidence-based practice is openly used/welcomed by staff? What strategies might you use to overcome any barriers you might face? How will you capitalize upon any facilitators you have identified?

This section restates what was written in Chapter 3 and provides supporting citations for key points. Your summary should demonstrate an in-depth understanding of the overall project design and analysis techniques. The Chapter 3 summary ends with a discussion that transitions the reader to Chapter 4. Comment by Author: Use INSERTPage Break to set new page for the reference list.

The purpose of this chapter is to summarize the collected data, how it was analyzed and then to present the results. This section of Chapter 4 briefly restates the problem statement, the methodology, the clinical question(s) or phenomena, and then offers a statement about what will be covered in this chapter. Chapter 4 should present the results of the project as clearly as possible, leaving the interpretation of the results for Chapter 5. Make sure this chapter is written in past tense and reflects how the project was
actually conducted.

This chapter typically contains the analyzed data, often presented in both text and tabular or figure format. To ensure readability and clarity of findings, structure is of the utmost importance in this chapter. Sufficient guidance in the narrative should be provided to highlight the findings of greatest importance for the reader. Most investigators begin with a description of the sample and the relevant demographic characteristics presented in text or tabular format.

Ask the following general questions before starting this chapter: Comment by Author: Edit the style (FORMAT–>STYLE–> Modify–>(drop down box that says format)–>Paragraph–> set indentation Left 0.25″, Special = hanging; by= 0.5″ THEN click on TABS (lower left corner) and make sure it is set at .75″ edit the style (FORMAT–>STYLE–> Modify–>(drop down box that says format)–>Paragraph–> set indentation Left 0.25″, Special = hanging; by= 0.5″ THEN click on TABS (lower left corner) and make sure it is set at .75″

Is there sufficient data to answer each of the clinical question(s) asked in the project? (see Appendix C) One procedure for determining a sample size ahead of the project is a power analysis.

Is there sufficient data to support the conclusions you will make in Chapter 5? (see Appendix D) If using SPSS version 26 to perform analyses, the data is entered and coded using numbers or numerical codes.

Is the project written in the third person? Never use the first person.

Is the data clearly explained using a table, graph, chart, or text? (see Appendix E)

Visual organizers, including tables and figures, must always be introduced, presented and discussed within the text first. Never insert them without these three steps. It is often best to develop all of the tables, graphs, charts, etc. before writing any text to further clarify how to proceed. Point out the salient results and present those results by table, graph, chart, or other form of collected data. See Appendix E for examples of APA formatted tables and figures.

This section of Chapter 4 provides a narrative summary of the population or sample characteristics and demographics of the participants in the project. It establishes the number of subjects, gender, age, education level or employee classification, (if appropriate), organization, or setting (if appropriate), and other appropriate sample characteristics (e.g. education level, program of project, employee classification etc.). The use of graphic organizers, such as tables, charts, histograms and graphs to provide further clarification and promote readability, is encouraged to organize and present coded data. Ensure this data cannot lead to anyone identifying individual participants in this section or identifying the data for individual participants in the data summary and data analysis that follows.

For numbers, equations, and statistics, spell out any number that begins a sentence, title, or heading – or reword the sentence to place the number later in the narrative. In general, use Arabic numerals (10, 11, 12) when referring to whole numbers 10 and above, and spell out whole numbers below 10. There are some exceptions to this rule:

If small numbers are grouped with large numbers in a comparison, use numerals (e.g., 7, 8, 10, and 13 trials); but, do not do this when numbers are used for different purposes (e.g., 10 items on each of four surveys).

Numbers in a measurement with units (e.g., 6 cm, 5-mg dose, 2%).

Numbers that represent time, dates, ages, sample or population size, scores, or exact sums of money.

Numbers that represent a specific item in a numbered series (e.g., Table 1).

A sample table in APA style is presented in Table 3. Be mindful that all tables fit within the required margins, and are clean, easy to read, and formatted properly using the guidelines found in Chapter 5 (Displaying Results) of the APA
Publication Manual 7th Edition. Comment by Author: Each table must be numbered in sequence throughout the entire practice improvement project (Table 1, Table 2, etc.), or within chapters (Table 1.1, Table 1.2 for Chapter 1; Table 2.1, Table 2.2 for Chapter 2 etc.).

Note. Adapted from “Sampling and Recruitment in Studies of Doctoral Students,” by I.M. Investigator, 2010,
Journal of Perspicuity, 25, p 100. Reprinted with permission. Comment by Author: Permission must be obtained to reprint information that is not in the public domain. Letters of permission are included in the appendix.

This section presents a description of the process that was used to analyze the data. If clinical question(s) guided the project, data analysis procedures can be framed relative to each clinical question. Data can also be organized by chronology of phenomena, by themes and patterns, or by other approaches as deemed appropriate according for the project. The key components included in this section are:

A detailed description of the data analysis procedures.

An explanation of how the raw data relates to the clinical questions(s) asked in the project for a quantitative project.

A discussion of the identification of sources of error and their effect on the data.

An explanation and justification of any differences in why the data analysis section does not match what was approved in Chapter 3 (if appropriate).

An analysis of the reliability and validity of the data in statistical terms, for quantitative projects.

This section, which is the primary section of this chapter, presents a summary and analysis of the data in a non-evaluative, unbiased, organized manner that relates to the clinical question(s). List the clinical question(s) as you are discussing them in order to ensure that the readers see that the question has been addressed. Answer the clinical question(s) in the order that they are listed for quantitative studies. The key components included in this section are:

The data and the analysis of that data should be presented in a narrative, non-evaluative, unbiased, organized manner by clinical question(s).

The section should also include appropriate graphic organizers, such as tables, charts, graphs, and figures.

The amount and quality of the data or information is sufficient to answer the clinical question(s) is well presented, and is intelligently interpreted.

Quantitative: Findings are presented by clinical question using section titles. They are presented in order of significance, if appropriate.

Quantitative: Results of each statistical test are presented in appropriate statistical format with tables, graphs, and charts.

Quantitative: For inferential statistics,
p-value and test statistics are reported.

Quantitative: Control variables (if part of the design) are reported and discussed. Outliers, if found, were reported.

The results must be presented without implication, speculation, assessment, evaluation, or interpretation. Discussion of results and conclusions are left for Chapter 5. Refer to the APA Style Manual for additional lists and examples. In quantitative practice improvement projects, it is not required for all data analyzed to be presented; however, it is important to provide descriptive statistics and the results of the applicable statistic tests used in conducting the analysis of the data. It is also important that there are descriptive statistics provided on all variables. Nevertheless, it is also acceptable to put most of this in the Appendix if the chapter becomes too lengthy.

Required components include descriptive and inferential statistics. Descriptive statistics describe or summarize data sets using frequency distributions (e.g., to describe the distribution for the IQ scores in your class of 30 pupils) or graphical displays such as bar graphs (e.g., to display increases in a school district’s budget each year for the past five years), as well as histograms (e.g., to show spending per child in school and display mean, median, modes, and frequencies), line graphs (e.g., to display peak scores for the classroom group), and scatter plots (e.g., to display the relationship between two variables). Descriptive statistics also include numerical indexes such as averages, percentile ranks, measures of central tendency, correlations, measures of variability and standard deviation, and measures of relative standing.

Inferential statistics describe the numerical characteristics of data, and then go beyond the data to make inferences about the population based on the sample data. Inferential statistics also estimate the characteristics of populations about population parameters using sampling distributions, or estimation. Table 4 presents example results of an independent
t test comparing Emotional Intelligence (EI) mean scores by gender.

t
-Test for Equality of Emotional Intelligence Mean Scores by Gender

After completing the first draft of Chapter 4, ask these general questions: Comment by Author: Use Line Spacing Options to “Add a Space Between Paragraph” between tables and the text following it

1. Are the findings clearly presented, so any reader could understand them?

Are all the tables, graphics or visual displays well-organized and easy to read?

Are the important data described in the text?

Is factual data information separate from analysis and evaluation?

Are the data organized by clinical questions?

Chapter 4 can be challenging with regard to mathematical equations and statistical symbols or variables. When including an equation in the narrative, space the equation as you would words in a sentence:
x + 5 =
a. Punctuate equations that are in the paragraph, as you would a sentence. Remember to italicize statistical and mathematical variables, except Greek letters, and if the equation is long or complicated, set it off on its own line.

Refer to your APA manual for specific details on representation of statistical information. Basic guidelines include:

Statistical symbols are italicized (
t, F, N, n)

Greek letters, abbreviations that are not variables and subscripts that function as identifiers use standard typeface, no bolding or italicization

Use parentheses to enclose statistical values (
p = .026) and degrees of freedom
t(36) = 3.85 or
F(2, 52) = 3.85

Use brackets to enclose limits of confidence intervals 95% CIs [- 5.25, 4.95]

Make sure to include appropriate graphics to present the results. Always
introduce,
present, and
discuss the visual organizers in narrative form. Never insert a visual organizer without these three steps.

A figure is a graph, chart, map, drawing, or photograph. Below is an example of a figure labeled per APA style. Do not include a figure unless it adds substantively to the understanding of the results or it duplicates other elements in the narrative. If a figure is used, a label must be placed under the figure. As with tables, refer to the figure by number in the narrative preceding the placement of the figure. Make sure a table or figure is not split between pages. Below is another example of a table and figure for you to review. (see Table 5 and Figure 4) Comment by Author: See Chapter 7 for details on correct APA style. Comment by Author: You must reference tables in the text prior to displaying the graphic.

The Servant Leader Comment by Author: In addition to numbering the table, name the table.

Note. Derived from
Laub, J. (1999). Assessing the servant organization: Development of the servant organizational leadership assessment (SOLA) instrument (Doctoral Practice improvement project). Available from ProQuest Practice improvement project and Theses Database. (UMI No. 9921922) Comment by Author: If at all possible, do not break a table across a page break.

Scattor Plot Example – Strong Negative Correlation

Note, An example of a strong negative correlation for SAT composite score and time spent on Facebook for 11th grade high school students enrolled in IMSmart SAT Prep Course.

This section provides a concise summary of what was found in the project. It briefly restates essential data and data analysis presented in this chapter, and it helps the reader see and understand the relevance of the data and analysis to the clinical question(s). Finally, it provides a lead or transition into Chapter 5, where the implications of the data and data analysis relative to the clinical question(s) will be discussed. The summary of the data must be logically and clearly presented, with the factual information separated from interpretation. For quantitative studies, summarize the statistical data and results of statistical tests in relation to the clinical question(s). Finally, provide a concluding section and transition to Chapter 5. Comment by Author: Use INSERTPage Break to set new page for new chapter. Do not use hard returns to get there.

This section introduces Chapter 5 as a comprehensive summary of the entire project. It reminds the reader of the importance of the topic and briefly explains how the project intended to contribute to the body of knowledge on the topic. It informs the reader that conclusions, implications, and recommendations will be presented.

Chapter 5 is perhaps the most important chapter in the practice improvement project manuscript because it presents the investigator’s contribution to the body of knowledge. For many who read evidence-based literature, this may be the only chapter they will read. Chapter 5 typically begins with a brief summary of the essential points made in Chapters 1 and 3 of the original DPI project and includes why this topic is important and how this project was designed to contribute to the understanding of the topic. The remainder of the chapter contains a summary of the overall project, a summary of the findings and conclusions, recommendations for future practice, and a final section on implications derived from the project.

No new data or citations should be introduced in Chapter 5; however, references should be made to findings or citations presented in earlier chapters. The investigator can articulate new frameworks and new insights. The concluding words of Chapter 5 should emphasize both the most important points of the project and what the reader should take from them. This should be presented in the simplest possible form, making sure to preserve the conditional nature of the insights. Refer to the Grand Canyon University practice improvement project rubric for guidance on the content of this chapter.

This section provides a comprehensive summary of the overall project that describes the content of the project to the reader in the simplest possible terms. It should recap the essential points of Chapters 1-3, but it should remain a broad, comprehensive view of the project. It reminds the reader of the clinical question(s) and the main issues being evaluated, and provides a transition, explains what will be covered in the chapter and reminds the reader of how the project was conducted.

This section of Chapter 5 is organized by clinical question(s), and it conveys the specific findings of the project. The section presents conclusions made based on the data analysis and findings of the project and relates the findings back to the literature, significance of the project in Chapter 1, advancing scientific knowledge in Chapter 1. Significant themes/ findings are compared and contrasted, evaluated and discussed in light of the existing body of knowledge. The significance of every finding is analyzed and related to the significance section and advancing scientific knowledge section of Chapter 1. Additionally, the significance of the findings is analyzed and related back to Chapter 2, and ties the project together. The findings are bounded by the DPI project parameters described in Chapters 1 and 3, are supported by the data and theory, and directly relate to the clinical question(s). No unrelated or speculative information is presented in this section. This section of Chapter 5 should be organized by clinical question(s), theme, or any manner that allows summarizing the specific findings supported by the data and the literature. Conclusions represent the contribution to knowledge and fill in the gap in the knowledge. They should also relate directly to the significance of the project. The conclusions are major generalizations, and an answer to the practice problem developed in Chapters 1 and 2. This is where the project binds together. In this section, personal opinion is permitted, as long as it is backed with the data, grounded in the project methods and supported in the literature.

This section should describe what could happen because of this project. It also tells the reader what the DPI project results imply theoretically, practically, and for the future. Additionally, it provides a retrospective examination of the theoretical framework presented in Chapter 2 in light of the practice improvement project’s findings. A critical evaluation of the strengths and weaknesses of the project, and the degree to which the conclusions are credible given the methodology, project design, and data, should also be presented. The section delineates applications of new insights derived from the practice improvement project to solve real and significant problems. Implications can be grouped into those related to theory or generalization, those related to practice, and those related to future projects. Separate sections with corresponding headings provide proper organization.

Theoretical implications involve interpretation of the practice improvement project findings in terms of the clinical question(s) that guided the project. It is appropriate to evaluate the strengths and weaknesses of the project critically and include the degree to which the conclusions are credible given the method and data. It should also include a critical, retrospective examination of the framework presented in the Chapter 2 Literature Review section in light of the practice improvement project’s new findings.

Practical implications should delineate applications of new insights derived from the practice improvement project to solve real and significant problems.

Two kinds of implications for future projects are possible: one based on what the project did find or do, and the other based on what the project did
not find or do. Generally, future DPI projects could look at different kinds of subjects in different kinds of settings, interventions with new kinds of protocols or dependent measures, or new theoretical issues that emerge from the project. Recommendations should be included on which of these possibilities are likely to be most fruitful and why.

Summarize the recommendations that result from the project. Each recommendation should trace directly to a conclusion.

This section should contain a minimum of four to six recommendations for future DPI projects, as well as a full explanation for why each recommendation is being made. Additionally, this section discusses the areas of project that need further examination, or addresses gaps or new patient or system needs the project found. The section ends with a discussion of “next steps” in forwarding this line of DPI project evaluations. Recommendations relate back to the project significance and advancing scientific knowledge sections in Chapter 1.

This section should contain two to five recommendations for future practice based on the results and findings of the project, as well as a full explanation for why each recommendation is being made. It provides a discussion of who will benefit from reading and implementing the results of the project and presents ideas based on the results that practitioners can implement in the work or educational setting. Unrelated or speculative information that is unsupported by data is clearly identified as such. Recommendations should relate back to the project significance section in Chapter 1.

GCU requires the
Publication Manual of the American Psychological Association (7th ed.) as the style guide for writing and formatting Direct Practice Improvement (DPI) Projects. . A DPI Project has three parts: preliminary pages, main text, and supplementary pages. Some preliminary or supplementary pages may be optional or not appropriate to a specific project. The learner should consult with his or her practice improvement project chairperson and committee regarding inclusion or exclusion of optional pages.

The following preliminary pages precede the main text of the practice improvement project.

Title Page

Copyright Page (optional)

Approval Page

Abstract

Dedication Page (optional)

Acknowledgements (optional)

Table of Contents

List of Tables (if you have tables, a list is required)

List of Figures (if you have figures, a list is required)

The main text is divided into five major chapters. Each chapter can be further subdivided into sections and subsections.

Chapter 1: Introduction to the Project

Chapter 2: Literature Review

Chapter 3: Methodology

Chapter 4: Data Analysis and Results (not included in the proposal)

Chapter 5: Summary, Conclusions, and Recommendations (not included in the proposal)

Supplementary pages, which follow the body text, include reference materials and other required or optional addenda.

References

Appendices

Appendix A for the manuscript is the Grand Canyon University IRB Outcome Letter.

Appendix B is the Instruments/tool used

Appendix C is permission to use the instrument/tool

Appendix D is another tool if applicable (Appendix E is permission for second instrument/tool) otherwise you are done.

2

THIS IS NOT PART OF THE PAPER JUST A REFERENCE FOR THE LEARNER

26

Note: Public source G-Power Software available https://www.psychologie.hhu.de/arbeitsgruppen/allgemeine-psychologie-und-arbeitspsychologie/gpower.html

26

The SPSS database is set up with all variables coded to compare between or within the comparison groups. A comparison may be made within the same individual and it coded 1 for before and 2 after the intervention. Or if measuring between individuals, the data would be coded the same 1 for before and 2 after as noted in the Group Column. Software supplied by Grand Canyon University.

Tables vs. Figures

0. See APA Publication Manual, Chapter 7 for additional details (APA, 2019).

0. Tables consist of words and numbers where spatial relationships usually do not indicate any numerical information.

0. Tables should be used to present information that would be too wordy, repetitive, or difficult to read as text.

0. Figures typically communicate numerical information using spatial relations. For example, as you move up the Y axis of bar graph the scores usually go up.

1.
Examples of APA Tables

A. Descriptive table

Table 1

Characteristics of Variables

Note. Add notes here = (Provide any reference, 2019).

Number of Handoff Per Groups

Note. SBAR handoff was defined as …. (IHI, 2020)

Table 1

Number of Hours Per Week Spent in Various Activities

Note. Schoolwork was defined as time spent doing class work outside of regular class time.

*statistically significant at
p <.05

B. Chi-Square example (Group IV x Group DV)

Table 1

Crosstabulation of Gender and Chronic Pain

Note. Adjusted standardized residuals appear in parentheses below group frequencies

**=
p
< .01.

C.
t-Test Example (Dichotomous Group IV x Score DV) –
Notice two separate
t-test results have been reported.

Table 1

Chronic Paint Score and Exercise time for Males and Females

Note. Standard Deviations appear in parentheses below means.

* =
p
< .05, *** =
p
< .001.

D. One Way ANOVA with 3 Groups Example (Group IV x Score DV)

Remember with an ANOVA, you have to report paired comparisons associated with post hoc or planned comparisons) for significant analyses. The results of paired comparisons are indicated by the subscripts on the means within rows. Also, notice in this table that we report the results of four separate analyses. This is the real power of tables: we can convey a large amount of information very concisely.

Table 1

Analysis of Variance for Sleep Times and Experimental Groups

Standard deviations appear in parentheses bellow means. Means with differing subscripts within rows are significantly different at the
p
< .05 based on Fisher’s LSD post hoc paired comparisons.

* =
p
< .05, *** =
p
< .001.

E. Factorial ANOVA Example 2 x 3 between subject’s design.

Notice that two tables are used here. The first table reports the overall results for the 2×3 factorial ANOVA, which includes the Main Effects for the two IV’s and the Interaction Effect for the two IV’s. The second table reports the means and simple effects tests for the significant interaction effect.

Table 1

Experimental Group x Sex Factorial Analysis of Variance for Sleep Scores

Table 1

Analysis of Sleep Scores for Experimental Groups by Gender

Note. Standard deviations appear in parentheses bellow means. Means with differing subscripts within rows are significantly different at the
p
< .05 based on Fisher’s LSD post hoc paired comparisons.

** =
p
< .01

Notice that the simple effect comparing the 3 experiment groups only for females, requires follow up tests in order to determine which groups are significantly different. In this case, Fisher’s LSD test was used, and the results are represented with the different subscripts for each mean. In this case, female participants in the Aerobic exercise group did not differ from the no exercise group so they are given the same subscript (a). However, women in the control group and women in the Weight lifting group significantly differed from the Aerobic watching group and so the Weight Lifting group was labeled with a different subscript (b). The male subjects did not differ from one another, so they all share the same subscript (a).

F. Correlations (Scores IV x Scores IV)

Table 1

Pearson’s Product Moment Correlations for Chronic Pain Score, Exercise Attitude Scores and Physical Activity

Note.
N = 96 for all analyses.

† =
p
< .10, *=
p
< .05, **=
p
< .01, ***=
p
< .001.

1.
Examples of APA Figures

Generally, the same features apply to figures as have been previously provided for tables: They should be easy to read and interpret, consistent throughout the document when presenting the same type of figure, kept on one page if possible, and supplement the accompanying text or table.

Figure 1

Graph of Scores Before and After

Identify the analysis technique.

In the results section (Chapter 4), your goal is to report the results of the data analyses used to answer your project question. To do this, you need to identify your data analysis technique, report your test statistic, and provide some interpretation of the results. Each analysis you run should be related to your clinical question or PICOT. If you analyze data that is exploratory or outside your clinical question, you need to indicate this in the results.

Format test statistics.

Test statistics and
p values

should be rounded to two decimal places
(If you are providing precise p-values for future use in meta-analyses, 3 decimal places is acceptable).

All statistical symbols (sample statistics) that are not Greek letters should be italicized (M, SD, t, p, etc.).

Indicate the direction of the significant difference.

When reporting a significant difference between two conditions, indicate the direction of this difference, i.e. which condition was more/less/higher/lower than the other condition(s). Assume that your audience has a professional knowledge of statistics. Do not explain how or why you used a certain test unless it is unusual (i.e., such as a non-parametric test).

How to report
p values.

Report the exact p value (this is the preferred option if you want to make your data convenient for individuals conducting a meta-analysis on the topic).

Example:
t(33) = 2.10,
p = .03.

If your exact p value is less than .001, it is conventional to state merely
p < .001. If you report exact p values, state early in the results section the alpha level used as a significance criterion for your tests. For example: “We used an alpha level of .05 for all statistical tests.”

If your results are in the predicted direction but are not significant, you can say your results were
marginally significant. Example: Results indicated a marginally significant preference for pie (
M = 3.45,
SD = 1.11) over cake (
M = 3.00,
SD = .80),
t(5) = 1.25,
p = .08.

If your p-value is over .10, you can say your results revealed a non-significant trend in the predicted direction. Example: Results indicated a non-significant trending in the predicted direction indicating a preference for pie (
M = 4.25,
SD = 2.21) over cake (
M = 3.25,
SD = 2.60),
t(5) = 1.75,
p = .26.

Descriptive Statistics

Mean and Standard Deviation are most clearly presented in parentheses:

The sample as a whole was relatively young (
M = 19.22,
SD = 3.45).

The average age of students was 19.22 years (
SD = 3.45).

Percentages are also most clearly displayed in parentheses with no decimal places:

Nearly half (49%) of the sample was married.

Frequencies or rates are reported including the range, mode, or median.

t-tests

There are several different designs that utilize a t-test for the statistical inference testing. The differences between one-sample t-tests, related measures t-tests, and independent samples t tests are clear to the knowledgeable reader so eliminate any elaboration of which type of t-test has been used. Additionally, the descriptive statistics provided will identify which variation was employed. It is important to note that we assume that all
p values represent two-tailed tests unless otherwise noted and that independent samples t-tests use the pooled variance approach (based on an equal variances assumption) unless otherwise noted:

There was a significant effect for gender,
t(54) = 5.43,
p < .001, with men receiving

higher scores than women.

Results indicate a significant preference for pie (
M = 3.45,
SD = 1.11) over cake (
M = 3.00,
SD = .80),
t(15) = 4.00,
p = .001.

The 36 study participants had a mean age of 27.4 (
SD = 12.6) were significantly older

than the university norm of 21.2 years,
t(35) = 2.95,
p = .01.

Students taking statistics courses in psychology at the University of Washington reported studying more hours for tests (
M = 121,
SD = 14.2) than did UW college students in general,
t(33) = 2.10,
p = .034.

The 25 participants had an average difference from pre-test to post-test anxiety scores of -4.8 (
SD = 5.5), indicating the anxiety treatment resulted in a significant decrease in

anxiety levels,
t(24) = -4.36,
p = .005 (one-tailed).

The 36 participants in the treatment group (
M = 14.8,
SD = 2.0) and the 25 participants in the control group (
M = 16.6,
SD = 2.5), demonstrated a significance difference in

performance (
t[59] = -3.12,
p = .01); as expected, the visual priming treatment inhibited

performance on the phoneme recognition task.

UW students taking statistics courses in Psychology had higher IQ scores (
M = 121,
SD = 14.2) than did those taking statistics courses in Statistics (
M = 117,
SD = 10.3),
t(44) =

1.23,
p = .09.

Over a two-day period, participants drank significantly fewer drinks in the experimental group (
M= 0.667,
SD = 1.15) than did those in the wait-list control group (
M= 8.00,
SD= 2.00),
t(4) = -5.51,
p=.005.

ANOVA and post hoc tests

ANOVAs are reported like the t test, but there are two degrees-of-freedom numbers to report. First report the between-groups degrees of freedom, then report the within-groups degrees of freedom (separated by a comma). After that report the F statistic (rounded off to two decimal places) and the significance level.

One-way ANOVA:

The 12 participants in the high dosage group had an average reaction time of 12.3

seconds (
SD = 4.1); the 9 participants in the moderate dosage group had an average

reaction time of 7.4 seconds (
SD = 2.3), and the 8 participants in the control group had a

mean of 6.6 (
SD = 3.1). The effect of dosage, therefore, was significant,
F(2,26) = 8.76,

p=.012.

An one way analysis of variance showed that the effect of noise was significant,
F(3,27) = 5.94,
p = .007. Post hoc analyses using the Scheffé post hoc criterion for significance indicated that the average number of errors was significantly lower in the white noise condition (
M = 12.4,
SD = 2.26) than in the other two noise conditions (traffic and industrial) combined (
M = 13.62,
SD = 5.56),
F(3, 27) = 7.77,
p = .042.

Tests of the four a priori hypotheses were conducted using Bonferroni adjusted alpha

levels of .0125 per test (.05/4). Results indicated that the average number of errors was

significantly lower in the silence condition (
M = 8.11,
SD = 4.32) than were those in both

the white noise condition (
M = 12.4,
SD = 2.26),
F(1, 27) = 8.90,
p =.011 and in the

industrial noise condition (
M = 15.28,
SD = 3.30),
F (1, 27) = 10.22,
p = .007. The

pairwise comparison of the traffic noise condition with the silence condition was nonsignificant.

The average number of errors in all noise conditions combined (
M = 15.2,
SD

= 6.32) was significantly higher than those in the silence condition (
M = 8.11,
SD = 3.30),

F(1, 27) = 8.66,
p = .009.

Multiple Factor (Independent Variable) ANOVA

There was a significant main effect for treatment,
F(1, 145) = 5.43,
p < .01, and a

significant interaction,
F(2, 145) = 3.13,
p < .05.

The cell sizes, means, and standard deviations for the 3×4 factorial design are presented

in Table 1. The main effect of Dosage was marginally significant (
F[2,17] = 3.23,
p =

.067), as was the main effect of diagnosis category,
F(3,17) = 2.87,
p = .097. The

interaction of dosage and diagnosis, however, has significant,
F(6,17) = 14.2,
p = .0005.

Attitude change scores were subjected to a two-way analysis of variance having two

levels of message discrepancy (small, large) and two levels of source expertise (high,

low). All effects were statistically significant at the .05 significance level. The main

effect of message discrepancy yielded an F ratio of
F(1, 24) = 44.4,
p < .001, indicating

that the mean change score was significantly greater for large-discrepancy messages (
M =

4.78,
SD = 1.99) than for small-discrepancy messages (
M = 2.17,
SD = 1.25). The main

effect of source expertise yielded an F ratio of
F(1, 24) = 25.4,
p < .01, indicating that the

mean change score was significantly higher in the high-expertise message source (
M =

5.49,
SD = 2.25) than in the low-expertise message source (
M = 0.88,
SD = 1.21). The

interaction effect was non-significant,
F(1, 24) = 1.22,
p > .05.

A two-way analysis of variance yielded a main effect for the diner’s gender,
F(1,108) =

3.93,
p < .05, such that the average tip was significantly higher for men (
M = 15.3%,
SD

= 4.44) than for women (
M = 12.6%,
SD = 6.18). The main effect of touch was nonsignificant,
F(1, 108) = 2.24,
p > .05. However, the interaction effect was significant,

F(1, 108) = 5.55,
p < .05, indicating that the gender effect was greater in the touch

condition than in the non-touch condition.

Chi Square

Chi-Square statistics are reported with degrees of freedom and sample size in parentheses, the Pearson chi-square value (rounded to two decimal places), and the significance level:

The percentage of participants that were married did not differ by gender,
X2(1, N = 90) = 0.89,
p > .05.

The sample included 30 respondents who had never married, 54 who were married, 26

who reported being separated or divorced, and 16 who were widowed. These frequencies

were significantly different,
X2 (3, N = 126) = 10.1,
p = .017.

As can be seen by the frequencies cross tabulated in Table xx, there is a significant

relationship between marital status and depression,
X2 (3, N = 126) = 24.7,
p < .001.

The relation between these variables was significant,
X2 (2, N = 170) = 14.14,
p < .01.

Catholic teens were less likely to show an interest in attending college than were

Protestant teens.

Preference for the three sodas was not equally distributed in the population,
X2 (2, N =

55) = 4.53,
p < .05.

Correlations

Correlations are reported with the degrees of freedom (which is N-2) in parentheses and the significance level:

The two variables were strongly correlated,
r(55) = .49,
p < .01.

Regression analyses

Regression results are often best presented in a table. A

PA doesn’t say much about how to report regression results in the text, but if you would like to report the regression in the text of your Results section, you should at least present the standardized slope (beta) along with the t-test and the corresponding significance level. (Degrees of freedom for the t-test is N-k-1 where k equals the number of predictor variables.) It is also customary to report the percentage of variance explained along with the corresponding F test.

Social support significantly predicted depression scores,
b = -.34,
t(225) = 6.53,
p < .01. Social support also explained a significant proportion of variance in depression scores, R2 = .12,
F(1, 225) = 42.64,
p < .01.

Tables

Add a table or figure.

Adding a table of figure can be helpful to the reader. See the current APA Publication manual for examples. In reporting the results of statistical tests, report the descriptive statistics, such as means and standard deviations, as well as the test statistic, degrees of freedom, obtained value of the test, and the probability of the result occurring by chance (
p value).

•APA style tables do not contain any vertical lines

•There are no periods used after the table number or title.

•When using columns with decimal numbers, make the decimal points line up.

•Use MS Word tables to create tables

American Psychological Association [APA].
(2019).
Publication manual of the American Psychological Association (7th ed.). Washington, DC: Author.

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