NRP/508 Week 8: Research Principles and Professional Development Plan, sample paper

Eleven Competencies, One Rural Clinic: A Research-Literate Professional Development Plan for a Family Nurse Practitioner's First Three Years

[Student Name]

University of Phoenix

NRP/508: Health Policy and Role of the Advanced Practice Nurse

Week 8 Assignment

[Instructor Name]

[Date]

The student author and clinic are composites written for a model paper.

Over eight weeks, this course has examined the history of my future role, its scope, the transition into it, its credentials, its policy and payment environment and its ethics. This final paper turns to two things I will carry into practice: the research principles that should govern how I use and produce evidence, and a plan for my own development over the first three years in a rural Texas clinic.

Research Principles for a Nurse Practitioner

Most nurse practitioners are users of research more often than producers. The first principle is appraisal: evidence must be judged for design, bias, size and relevance before it changes practice. A single striking study should not override a body of evidence or a guideline built on it.

The second principle is protection of participants. When a clinician collects data for research, participants must give informed consent, and the study must be reviewed by an ethics committee. The Belmont Report's principles, respect for persons, beneficence and justice, still frame this review.

The third principle is the distinction between quality improvement and research. A project that tests a change in my own clinic to improve care, such as a new diabetes follow-up process, is usually quality improvement. If I intend to produce generalizable knowledge and publish it as research, ethical review is needed. When uncertain, I will ask an institutional review board.

The fourth principle is honesty with data: reporting results that disappoint, not only successes, and never presenting a small project's findings as proof.

Evidence-Based Practice Competencies

Working with a panel of evidence-based practice mentors through two Delphi rounds, Melnyk et al. (2014) reached consensus on a set of competencies for registered nurses in practice, plus eleven more expected of advanced practice nurses. The advanced practice competencies include questioning current practice, searching for and appraising evidence, synthesizing it, leading implementation of practice changes, evaluating outcomes and mentoring others. The authors proposed using the competencies in orientation, job descriptions and performance appraisal.

The competencies describe a clinician who does not wait for guidelines to reach a rural clinic but brings the evidence there and checks whether it works.

Assessing Myself

I rated myself against the advanced practice competencies. I am strong at formulating clinical questions and searching databases, skills built in this program. I am moderate at critical appraisal of study designs and weak at leading practice change and evaluating outcomes with data, since I have never led an improvement project. Mentoring others is a future goal.

Goal 1: Clinical Competence (Year 1)

The first year is about becoming a safe, competent family nurse practitioner. Measures: completing a 12-week orientation, weekly case review with my delegating physician for three months, a log of challenging cases reviewed monthly and passing a chart audit at six and twelve months.

Goal 2: Appraisal Skills (Year 1)

I will join or form a monthly journal club with other rural nurse practitioners by video, appraising one study each month with a structured tool. Measure: 10 appraisals completed in the first year, with a short summary shared with the clinic.

Goal 3: Leading a Practice Change (Year 2)

In the second year, I will lead one quality improvement project on a clinic priority, such as improving diabetes control or colorectal cancer screening. Measures: a written project plan, baseline and follow-up data and a summary presented to the clinic board. Melnyk et al. (2014) describe leading practice change as a core advanced practice competency, and this project will build it.

Goal 4: Retention and Autonomy (Years 1 to 3)

Faraz (2017) found that professional autonomy was a critical factor in whether novice nurse practitioners in primary care intended to leave their positions. I will negotiate for autonomy within the clinic, over scheduling, panel size and clinical protocols, and review my job satisfaction each year. Measure: remaining in the position through year three, with an annual self-assessment.

Goal 5: Policy and Professional Contribution (Years 2 to 3)

I will serve on the state nurse practitioner association's legislative committee, submit testimony on at least one bill affecting practice and precept one nurse practitioner student by year three. A 2021 consensus study from the National Academies asks nurses to help achieve health equity through practice and policy (National Academies of Sciences, Engineering, and Medicine, 2021), and rural precepting helps build the workforce that such equity requires.

Using Evidence at the Point of Care

In daily practice, research principles take a simple form. When a question arises during a visit, such as whether a new drug is better than an old one for a particular patient, I will check a current guideline or a synthesized source first and note the question for deeper review at journal club if the answer is uncertain. When a patient brings a news story about a study, I will explain what kind of study it was and what it can and cannot show. These small habits are where evidence-based practice lives in a busy clinic.

Contributing to Research From a Rural Clinic

Rural clinics are underrepresented in research, and their patients are underrepresented in trials. A small clinic can contribute by joining a practice-based research network, which allows primary care practices to participate in studies without running them alone. I will explore whether a regional network accepts rural health clinics, and if so, whether our board would approve participation, with ethical review handled through the network.

Balancing Development With Practice

A plan with five goals could crowd out the clinical work that comes first. I have ordered the goals so that the first year focuses on clinical competence and appraisal, the second adds a practice change and the third adds policy and precepting. If the first year is harder than expected, the later goals will move, not the clinical ones.

Staying Current

Each year I will complete continuing education required for certification renewal, with at least a third focused on topics relevant to rural practice, such as agricultural injuries, heat illness and telehealth.

Support I Will Need

The plan depends on others: a mentor willing to meet quarterly, an employer that protects time for journal club and a quality project and a board open to change. I will ask for these commitments during hiring, in writing where possible, since a plan without support is a wish.

Reviewing the Plan

I will review this plan each year with my mentor, marking goals met, revised or dropped, and adding new goals as my practice develops.

Conclusion

Research principles, appraising evidence, protecting participants, separating quality improvement from research and reporting results honestly, will guide how I use evidence in a rural clinic. A published set of advanced practice competencies shows where I am ready and where I must grow, and a three-year plan with measurable goals in clinical competence, appraisal, practice change, retention and policy gives that growth a path.

References

Faraz, A. (2017). Novice nurse practitioner workforce transition and turnover intention in primary care. Journal of the American Association of Nurse Practitioners, 29(1), 26-34. https://doi.org/10.1002/2327-6924.12381

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15. https://doi.org/10.1111/wvn.12021

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press. https://doi.org/10.17226/25982