please create a discussion post following the instructions and the rubric. Please also use the resources provided
Instructions: Post a response to the following prompts:
Rubric: RESPONSIVENESS TO DISCUSSION QUESTION (20 possible points): Discussion posts minimum requirements: The original posting must be completed by Day 3 at 11:59pm ET. Two response postings to two different peer original posts, on two different days, are required by Day 6 at 11:59pm ET.
Faculty member inquiries require responses, which are not included in the peer posts. Your Discussion Board postings should be written in Standard Academic English and follow APA 7 style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s learning resources as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.)
20 to >19.0 ptsExcellent• Discussion postings and responses are responsive to and exceed the requirements of the Discussion instructions. • The student responds to the question/s being asked or the prompt/s provided. Goes beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated) • Demonstrates that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Detailed response to faculty.
19 to >15.0 ptsGood• Discussion postings and responses are responsive to and meet the requirements of the Discussion instructions. • The student responds to the question/s being asked or the prompt/s provided. • Demonstrates that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Appropriate reply to faculty.
15 to >12.0 ptsFair• Discussion postings and responses are somewhat responsive to the requirements of the Discussion instructions. • The student may not clearly address the objectives of the discussion or the question/s or prompt/s. • Minimally demonstrates that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Brief response to faculty with minimal effort.
12 to >0 ptsPoor• Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. • Does not clearly address the objectives of the discussion or the question/s or prompt/s. • Does not demonstrate that the student has read, viewed, and considered a variety of learning resources, as well as resources available through the Walden University library and other credible online resources (guidelines, expert opinions etc.) • Fails to respond to faculty inquiries.
20 pts
This criterion is linked to a Learning OutcomeCONTENT REFLECTION and MASTERY: Initial Post (30 possible points)
30 to >29.0 ptsExcellentInitial Discussion posting: • Post demonstrates mastery and thoughtful/accurate application of content and/or strategies presented in the course. • Posts are substantive and reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. • Initial post is supported by 3 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings.
29 to >23.0 ptsGoodInitial Discussion posting: •
Posts demonstrate some mastery and application of content, applicable skills, or strategies presented in the course. • Posts are substantive and reflective, with analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. • Initial post is supported by 3 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings.
23 to >18.0 ptsFairInitial Discussion posting: • Post may lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. • Posts demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors. • There is a lack of support from relevant scholarly research/evidence.
18 to >0 ptsPoorInitial Discussion posting: • Post lacks in substance, reflection, analysis, or synthesis. • Posts do not generalize, extend thinking or evaluate concepts and issues within the topic or context of the discussion. • Relevant examples and scholarly resources are not provided.
30 pts
This criterion is linked to a Learning OutcomeCONTRIBUTION TO THE DISCUSSION: First Response (20 possible points)
20 to >19.0 ptsExcellentDiscussion response: • Significantly contributes to the quality of the discussion/interaction and thinking and learning. • Provides rich and relevant examples and thought-provoking ideas that demonstrates new perspectives, and synthesis of ideas supported by the literature. • Scholarly sources are correctly cited and formatted. • First response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Posts on separate day.
19 to >15.0 ptsGoodDiscussion response: • Contributes to the quality of the interaction/discussion and learning. • Provides relevant examples and/or thought-provoking ideas • Scholarly sources are correctly cited and formatted. • First response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Posts on separate day.
15 to >12.0 ptsFairDiscussion response: • Minimally contributes to the quality of the interaction/discussion and learning. • Provides few examples to support thoughts. • Information provided lacks evidence of critical thinking or synthesis of ideas. • There is a lack of support from relevant scholarly research/evidence. • Posts on separate day.
12 to >0 ptsPoorDiscussion response: • Does not contribute to the quality of the interaction/discussion and learning. • Lacks relevant examples or ideas. • There is a lack of support from relevant scholarly research/evidence. • Posts on same day.
20 pts
This criterion is linked to a Learning OutcomeCONTRIBUTION TO THE DISCUSSION: Second Response (20 possible points)
20 to >19.0 ptsExcellentDiscussion response: • Significantly contributes to the quality of the discussion/interaction and thinking and learning. • Provides relevant examples and thought-provoking ideas that demonstrates new perspectives, and extensive synthesis of ideas supported by the literature. • Second response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Scholarly sources are correctly cited and formatted. • Posts on separate day.
19 to >15.0 ptsGoodDiscussion response: • Contributes to the quality of the interaction/discussion and learning. • Provides relevant examples and/or thought-provoking ideas • Second response is supported by 2 or more relevant examples and research/evidence from a variety of scholarly sources including course and outside readings. • Scholarly sources are correctly cited and formatted. • Posts on separate day.
15 to >12.0 ptsFairDiscussion response: • Minimally contributes to the quality of the interaction/discussion and learning. • Provides few examples to support thoughts. • Information provided lacks evidence of critical thinking or synthesis of ideas. • Minimal scholarly sources provided to support post. • Posts on separate day.
12 to >0 ptsPoorDiscussion response: • Does not contribute to the quality of the interaction/discussion and learning. • Lacks relevant examples or ideas. • No sources provided. • Posts on same day.
20 pts
This criterion is linked to a Learning OutcomeQUALITY OF WRITING (10 possible points)
10 to >9.0 ptsExcellentDiscussion postings and responses exceed doctoral level writing expectations: • Use Standard Academic English that is clear, concise, and appropriate to doctoral level writing. • Make few if any errors in spelling, grammar, that does not affect clear communication. • Uses correct APA 7 format as closely as possible given the constraints of the online platform. • Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.
9 to >8.0 ptsGoodDiscussion postings and responses meet doctoral level writing expectations: • Use Standard Academic English that is clear and appropriate to doctoral level writing • Makes a few errors in spelling, grammar, that does not affect clear communication. • Uses correct APA 7 format as closely as possible given the constraints of the online platform. • Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints.
8 to >6.0 ptsFairDiscussion postings and responses are somewhat below doctoral level writing expectations: • Posts contains multiple spelling, grammar, and/or punctuation deviations from Standard Academic English that affect clear communication. • Numerous errors in APA 7 format • May be less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.
6 to >0 ptsPoorDiscussion postings and responses are well below doctoral level writing expectations: • Posts contains multiple spelling, grammar, and/or punctuation deviations from Standard Academic English that affect clear communication. • Uses incorrect APA 7 format • Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
10 pts
Total Points: 100
Resources: Bissett, K., Ascenzi, J., & Whalen, M. (2025). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines(5th ed.). Sigma Theta Tau International Honor Society of Nursing.
Discussion Post
Evidence-based practice (EBP) relies on the distinction between a nursing research and quality improvement (QI)/Doctor of Nursing Practice (DNP) project. Research aims at producing new knowledge as underlined by Bissett et al. (2025) but QI and DNP projects aim at translating available evidence to practice in order to enhance patient outcomes. A case study of a nursing research study by Emsden et al. (2020) and the QI DNP project by Hicks (2024) will show how a nursing problem can characterize knowledge gaps as well as practice gaps, eventually transforming into quantifiable outcomes and affecting the change in nursing practice.
Nursing Problems and the knowledge gap versus practice.
In the research study conducted by Emsden et al. (2020), the implicit nursing problem is the issue of the inability to adequately evaluate pain in heterogeneous patients of the ICU. Severely sick individuals are usually unable to experience pain as a result of sedation, mechanical ventilation or consciousness distortions. This poses a question of the validity and reliability of behavioral pain assessment tools. The issue represents an issue of knowledge: the decision on whether an existing pain assessment instrument is psychometrically valid in different populations of the ICU or not.
Salkind and Frey (2025) state that the measurement tools must possess the following important attributes to ensure that the clinical results can be interpreted accurately: reliability and validity. Emsden et al. (2020) have resolved this methodological issue by assessing the construct validity and interrater reliability. In this way, the research problem establishes a research gap, whether the tool is indeed able to measure pain and reliably and consistently in a diverse sample of ICU patients.
Conversely, the QI DNP project by Hicks (2024) deals with central line-associated bloodstream infections (CLABSIs). The underlying issue in nursing is the prevalence of CLABSIs when evidence based guidelines have already been made in place to prevent the occurrence of such infections. This is a practice gap, rather than a knowledge gap. There are already evidenced-based bundles that can be used to prevent CLABSI, but the problem is that the implementation or its compliance is not consistent, and it continues to pose a risk to patient safety.
This difference is well explained by Bissett et al. (2025): research questions are: What is the evidence? QI inquires, as opposed to this, where do we utilize the evidence in this context? Hicks (2024) assesses the compliance with CLABSI preventing measures and the patient outcomes after implementing the strategies that indicates a practice gap, which does not include the necessity to produce new theoretical knowledge.
Problem Presentation and Influence on Practice Change Comparison.
The issues in the two projects are posed differently and affect the change of nursing practice differently.
In Emsden et al. (2020), the issue is introduced as an uncertainty in psychometrics. It is concerned with measurement accuracy, statistical testing and validation. The change in the nursing practice is indirect but supporting: the demonstration of a pain assessment tool strengthens clinical beliefs in pain scoring, which could contribute to the improvement of pain management guidelines. The change is supported by evidence and helps to enlarge the generalizable knowledge.
However, Hicks (2024) presents the problem as a clinical outcome issue that has direct patient safety implications. The issue is organizational and situational. The objective is to have a structured improvement in the infection rates by means of structured intervention and assessment. The change practice is localized and direct as it is in line with DNP scholarship, which focuses on the improvement of the system at the level (Bissett et al., 2025).
Although research can eventually be used to guide guidelines at the national or international level, QI/DNP projects have an impact on individual practice environments and tend to follow iterative change frameworks, including Plan-Do-Study-Act (PDSA). Therefore, the two methods facilitate positive nursing practice change, but at different levels- knowledge generation and knowledge translation.
Measurement/Variables to be used in each Project.
In every project/study, measurable variables are outlined according to the purpose of the projects:
Emsden et al. (2020) –
One of the major variables is interrater reliability of the pain assessment tool. Statistical measurement of this was taken to identify the consistency between raters. The reliability analysis is also in line with the discussion of Salkind and Frey (2025) on the precision of measurement to achieve trustworthiness of clinical data.
Hicks (2024) –
One of them is the CLABSI rate/ 1,000 central line days, which is a centralized infection measure that is common with infection control benchmarking. This is an outcome measure that will be a direct measure of patient safety and quality performance.
EBP Question (Johns Hopkins Model)-
A key variable during the stage of practice question is commonly the patient outcome measure, which can be infection reduction or symptom improvement using the Johns Hopkins EBP model (Bissett et al., 2025). The quantifiable outcome in the context of CLABSI prevention is in line with the rates of infection incidence after evidence-based bundle implementation.
Both projects show consistency between the problem statement and the chosen variable, which is of primary importance in terms of methodological integrity.
Question Development Tool Critique: Hicks (2024) Question Development Tool.
Johns Hopkins EBP PET process ( Practice question, Evidence, Translation ) is represented in the Hicks (2024) Question Development Tool. When critiquing the tool, three domains are taken into account, including problem clarity, EBP question construction, and measurement alignment.
Problem Clarity:
The issue is well stated as sustained CLABSI rates in a specific clinical environment. It corresponds with the recommendation of Bissett et al. (2025) according to which practice problems should be specific, measurable, and outcome-oriented. The tool is effective in the process of correlating organizational data with the need that is identified to be improved.
EBP Question Construction:
The EBP question is designed in the form of a PICOT format with population, intervention, comparison, outcome, and timeframe. The organized methodology increases the evidence searchability and clarity (Bissett et al., 2025). Nonetheless, the possible weakness is the extent to which contextual variables (e.g., staffing ratios or compliance barriers) were included as a part of the question to capture the complexity of the real world.
Measurement Alignment:
The CLABSI rates are measured in an appropriate, objective and benchmarkable manner. Nevertheless, although there is a robust outcome measurement, other process measures, like adherence to the elements of the insertion bundle, may provide greater causal inference. According to Salkind and Frey (2025), the evaluation process should be conducted using good measurement instruments and using the right statistical interpretation.
In general, the Hicks (2024) tool has a good fit between problem identification, question creation, and quantifiable results. It demonstrates the good translation of evidence into clinical improvement without compromising on the methodology.
References
Bissett, K., Ascenzi, J., & Whalen, M. (2025). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (5th ed.). Sigma Theta Tau International.
Emsden, C., Schäfer, U. B., Denhaerynck, K., Grossmann, F., Frei, I. A., & Kirsch, M. (2020). Validating a pain assessment tool in heterogeneous ICU patients: Is it possible? Nursing in Critical Care, 25(1), 8–15. https://doi.org/10.1111/nicc.12469
Hicks, T. (2024). Quality evaluation of a central line associated bloodstream infection. Walden University CAO Repository.
Salkind, N., & Frey, B. (2025). Statistics for people who (think they) hate statistics (8th ed.). SAGE Publications.
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