| Course | DNP 750 DNP Applied Project I (DNP/750) |
|---|---|
| Week | 2 |
| Paper type | Purpose statement and PICOT question |
| Length | about 1,254 words, 5 double-spaced pages plus title page and references |
| Format | APA 7 student paper |
| School | University of Phoenix |
| Program | DNP |
| Updated | September 2026 |
Free sample paper for DNP 750 Week 2
From Problem to Question: A Purpose Statement and PICOT Practice Question for a Twelve-Week Diabetes Distress Screening Project in Primary Care
[Student Name]
University of Phoenix
DNP/750: DNP Applied Project I
Week 2 Assignment
[Instructor Name]
[Date]
The health center, staff and figures are composites written for a model paper.
Last week I identified the practice problem for my DNP applied project: at one federally qualified health center site, adults with type 2 diabetes complete a depression screen every year, yet nobody asks them about diabetes distress, which affects roughly one patient in three and tracks with A1C. Here that problem becomes a statement of purpose and an answerable question. It explains each element of the question, defines its terms so they can be measured, and sets objectives for the project.
Purpose Statement
The purpose of this quality improvement project is to implement routine diabetes distress screening, with a structured follow-up pathway, for adults with type 2 diabetes seen at a single primary care site of our health center, and to evaluate its effect on the identification of distress, timely follow-up and distress levels over 12 weeks.
A First Draft and Its Problems
My first draft asked, "Does addressing diabetes distress improve diabetes outcomes in low-income adults?" It failed on several counts. It named no specific intervention, no comparison and no time frame. "Diabetes outcomes" could mean anything from A1C to amputations. It read as a research question about cause rather than a question about changing practice, and answering it would take a trial far beyond a DNP project.
The Practice Question
Among adults with type 2 diabetes who attend a primary care site run by a federally qualified health center (P), does implementing DDS2 screening at diabetes visits, followed by the 17-item Diabetes Distress Scale and a registered nurse care manager pathway for those who screen positive (I), compared with current practice of depression screening alone (C), increase the proportion of patients screened for distress, the proportion of positive screens receiving follow-up within 14 days, and reduce distress scores among those who screen positive (O), over 12 weeks (T)?
Population
Eligible patients are adults aged 18 or older whose problem list includes type 2 diabetes who attend a diabetes-related visit at the site during the 12-week implementation period. Patients with type 1 diabetes are excluded because distress in type 1 has different content and a different scale. Patients with cognitive impairment documented in the chart, or who are in active crisis at the visit, will be managed through existing processes rather than the screening workflow.
Intervention
The intervention has three steps. First, medical assistants will give patients the DDS2, two items asking how much distress they feel from being overwhelmed by the demands of diabetes and from feeling they are failing with their regimen, each rated from 1 to 6. Fisher et al. (2008) developed the DDS2 from the longer scale and found that an average score of 3 or higher identified patients with moderate or high distress with a sensitivity of .95 and specificity of .85. Second, patients who screen positive will complete the full 17-item Diabetes Distress Scale (Polonsky et al., 2005), which shows which domains of distress are driving the score. Third, the care manager will review results with the patient that day or by phone within 14 days and choose a response matched to the domain and level, from problem-solving support to referral to the behavioral health consultant.
Comparison
The comparison is current practice at the same site: annual depression screening with the PHQ-2 and PHQ-9 and no structured distress assessment. Data from the 12 weeks before implementation will serve as the baseline.
Outcomes
Three outcomes answer the question. The first is the screening rate, defined as the number of eligible diabetes visits with a documented DDS2 divided by all eligible diabetes visits. The second is timely follow-up, defined as the proportion of positive DDS2 screens with a documented care manager contact within 14 days. The third is the change in the 17-item scale's mean item score between the first assessment and a repeat at 12 weeks among patients who screened positive. Fisher et al. (2012) found that distress effects on A1C and self-care began at low levels, and proposed three groups by mean item score: little or no distress below 2.0, moderate distress from 2.0 to 2.9 and high distress at 3.0 or above. These levels will be used to report change.
Time Frame
Twelve weeks allows most patients with type 2 diabetes to attend at least one diabetes visit, since the site schedules them every three months, and allows a repeat scale for those who screen positive early in the period. A1C will be recorded as an exploratory measure only, because 12 weeks is too short to expect a meaningful change.
Objectives
By the end of week 12, at least 80% of eligible diabetes visits will include a documented DDS2. At least 85% of positive screens will receive a care manager contact within 14 days. Among patients with a repeat scale, the mean item score will decline, with the proportion in the high distress group falling by at least a quarter. All medical assistants and care managers will complete training before the first week of implementation.
A Practice Question, Not a Research Question
The project does not test whether distress screening works in general; the development and validation of the tools, and the association between distress and outcomes, are already established. It asks whether putting this evidence into practice at one site improves identification and follow-up. For that reason the design will compare the site's own measures before and after the change as a quality improvement effort, and its findings will describe change at this site rather than claim generalizable causation.
Link to the Evidence Search
The question sets the terms for next week's literature search: diabetes distress, screening, DDS2 and the Diabetes Distress Scale, primary care, care management and type 2 diabetes. Interventions that reduce distress will also be searched, since the pathway needs evidence that follow-up helps.
Assumptions Built Into the Question
The question rests on three assumptions that later weeks must check. The first is that medical assistants can add two items to rooming without delaying visits, which the first improvement cycle will measure in minutes. The second is that patients will answer honestly on a tablet in the exam room; the patient advisory council will review the wording and the explanation that answers go only to the care team. The third is that the care managers have capacity for the expected positive screens. If about a third of screened patients score positive and about 200 patients are seen in 12 weeks, the care managers will need roughly 65 additional contacts, or five to six a week, which they have agreed is manageable.
Measurability at the Site
Each outcome can be pulled from the electronic health record once the screening form exists. Eligible visits are identified by diagnosis code and visit type, the screen and full scale are structured fields, and care manager contacts are already documented as encounters with dates. The quality coordinator has confirmed that a weekly report can list each measure. Nothing in the question depends on chart abstraction by hand, which protects the project from gaps in data collection during busy weeks.
Conclusion
The purpose statement and practice question translate a gap in care into a project that can be completed and measured at one site in 12 weeks. Each element has been defined so that the outcomes can be counted from the record, and objectives set targets for success. The question is aligned with the problem and framed as practice improvement, which prepares the evidence summary to come.
References
Fisher, L., Glasgow, R. E., Mullan, J. T., Skaff, M. M., & Polonsky, W. H. (2008). Development of a brief diabetes distress screening instrument. Annals of Family Medicine, 6(3), 246-252. https://doi.org/10.1370/afm.842
Fisher, L., Hessler, D. M., Polonsky, W. H., & Mullan, J. (2012). When is diabetes distress clinically meaningful? Establishing cut points for the Diabetes Distress Scale. Diabetes Care, 35(2), 259-264. https://doi.org/10.2337/dc11-1572
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing psychosocial distress in diabetes: Development of the Diabetes Distress Scale. Diabetes Care, 28(3), 626-631. https://doi.org/10.2337/diacare.28.3.626
What the DNP 750 Week 2 instructions ask
In DNP 750 Week 2, students usually write the purpose statement for the DNP applied project and the practice question that will guide it, most often in PICOT format. The prompt typically asks for each PICOT element to be identified and explained, for key terms to be defined in measurable ways, and for the question to be aligned with the problem statement from Week 1. Some sections ask for project objectives as well, or for a short explanation of why the question suits an evidence-based practice or quality improvement project rather than original research. The paper often runs three to five pages. Faculty treat this week as a gate: a clear, answerable question makes the evidence search in Week 3 and the methods in later weeks much easier to write.
How this DNP 750 Week 2 example is built
The paper begins with the Week 1 problem statement so the reader can check alignment. It then writes a one-paragraph purpose statement and shows a first draft of the practice question that was too broad, explaining what was wrong with it. The revised PICOT question names the population, the intervention with its two screening steps and pathway, the comparison with current practice, three outcomes and a 12-week time frame. Each element gets its own section with operational definitions, including the DDS2 cut point from Fisher and colleagues and the DDS17 levels from their later study. Objectives with targets follow. A closing section separates this quality improvement question from a research question and shows how the question links to next week's evidence search.
DNP 750 Week 2 grading rubric: where the points go
Faculty usually give most of the points in this assignment to the quality of the practice question: each PICOT element present, specific and measurable, and the whole question answerable within the project's scope and time frame. Alignment with the problem statement carries weight too, since a question that drifts from the problem forces later revisions. Rubrics often include operational definitions and measurable objectives as separate criteria. A smaller share of points goes to explaining why the question fits a DNP practice project and to scholarly writing and APA format. Questions that name a validated tool, a realistic time frame and outcomes the site can actually collect tend to earn full marks, while questions that promise to show a clinical outcome the project cannot measure lose points.
DNP 750 Week 2 help: mistakes to avoid
A frequent mistake is writing a research question, such as whether distress causes poor glycemic control, when the DNP applied project asks whether a practice change improves care. Frame the question around implementing the evidence. Another is leaving the comparison empty or writing no intervention; in a practice project, the comparison is usually current practice at the site. Students also pick outcomes they cannot collect in time, such as a change in A1C over a year, so match the outcome to the time frame. Define every term; "screening" and "follow-up" need numbers and deadlines. Finally, keep the purpose statement short, one or two sentences, and make sure its wording matches the question word for word where they overlap.
Related DNP 750 sample papers
Other DNP 750 week samples
- DNP 750 Week 1: Practice Problem and Significance
- DNP 750 Week 3: Evidence Summary for the Intervention
- DNP 750 Week 4: Translational Framework
- DNP 750 Week 5: Design, Setting and Stakeholders
- DNP 750 Week 6: Methods, Measures and Data
- DNP 750 Week 7: Feasibility, Ethics and Site Approval
- DNP 750 Week 8: DNP Applied Project Precis
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DNP 750 Week 2 questions, answered
What does DNP/750 Week 2 usually ask for?
Many sections ask students to write the purpose statement and a PICOT practice question for the DNP applied project, with each element explained and key terms defined.
Where can I find a free DNP 750 Week 2 sample paper?
Read the complete Week 2 paper above; it builds a PICOT question for a diabetes distress screening project, with margin notes explaining each step. Custom samples for your own question are free on the first order.
What does PICOT stand for?
Population, intervention, comparison, outcome and time; together they make a practice question specific enough to search for evidence and to measure.
How is a DNP practice question different from a research question?
A practice question asks whether putting existing evidence into practice improves care at a site, while a research question seeks new knowledge, such as whether one factor causes another.
What cut point does the DDS2 use?
In its development study, an average item score of 3 or higher on the two-item screen separated patients with moderate or high distress from those with low distress.
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