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Practice Question: In adult patients aged 18 years and older with a diagnosis of depression, will implementing the National Institute for Health and Care Excellence (NICE) Guidelines for exercising impact depression scores over 8-10 weeks?

Which DNP Essentials could be demonstrated in your scholarly project?

The DNP essential I demonstrate in my scholarly project is essential V1, interpersonal collaboration for improving patient outcomes.

            The aim of my project is to decrease symptoms of depression in patients with the diagnosis of mild to moderate depression using routine physical exercise such as walking.  Numerous studies have demonstrated the effectiveness of exercise in reducing depression and depression symptoms (Bigarella et al., 2021; Hu et al., 2020; Lok et al., 2017; NICE, 2009).  In some studies, the effects of exercise in reducing depression symptoms were comparable to the effects of antidepressant medications on depression (Blumenthal et al., 2007). In others, exercise was used as an intervention or treatment ally for the management of depression and depressive symptoms (Bigarella et al., 2021; Hu et al., 2020; Lok et al., 2017; NICE, 2009).

 Exercise or physical activity is evidence-based, non-pharmacologic, affordable, cost-effective, highly tolerable, and easy to perform without significant adverse effects (Bigarella et al., 2021; Hu et al., 2020; Lok et al., 2017; NICE, 2009). The DNP student cannot successfully single-handedly implement the project rather its success requires a team-based approach. The successful implementation of my project requires great interpersonal collaboration between the DNP student, practicum site leadership, staff, therapists, nurses, and providers. The DNP student collaborates with the rest of the mentioned team members to help recruit participants, educate, collect data, implement, evaluate, and sustain the change. Together, the team implements the change so patients outcomes can be improved.

Does your project idea consist of breadth and depth of knowledge within a defined area? Is there the potential for innovation and creativity to affect an outcome?

Yes, my project idea consists of breadth and depth of knowledge within a defined area of mental health. Walking exercise is implemented to help patients with the diagnosis of mild to moderate depression improve their quality of life, improve mood, and live a well-fulfilled life worthy of celebrating. Patients are equipped with creative and innovative ways to help improve their lives. Participants are encouraged to use applications such as MyFitnessPal which they already have in-built unto their phones to help them track and record their walks.

What areas of expertise and passion do you bring that you can build on? What skill sets do you need to develop to successfully implement your DNP project?

As a Certified Registered Nurse Anesthetist, I must successfully collaborate with other members of the team daily as I provide anesthesia so patients will have positive outcomes. I must communicate and collaborate with my anesthesiologist, the surgeon, nursing staff, and the patients to deliver safe and effective anesthesia. These are great skills I must bring on for the successful implementation of my project.

What skill sets do you need to develop to successfully implement your DNP project?

The ability to delegate and let go is an area Im continuing to develop. For the successful implementation and sustenance of my project, I must educate and delegate the project to the practicum site staff so they can join in the implementation of the project. I am not at the site daily and must leave the site at the end of my DNP program. I must therefore educate and delegate the project tasks to the staff so they can successfully carry out the project with or without me.

Please provide your instructor and student colleagues with an update on the implementation phase of your DNP Project. Share any successes, challenges, or barriers you experienced this week.

This week I revised and completed the final draft of my literature synthesis and the evidence-based portion of my DNP proposal. I look forward to successful advancement into the final week of this course.

References

 Bigarella, L. G., Ballotin, V. R., Mazurkiewicz, L. F., Ballardin, A. C., Rech, D. L., Bigarella, R. L., & Selistre, L. d. S. (2021). Exercise for depression and depressive symptoms in older adults: An umbrella review of systematic reviews and meta-analyses. Aging & Mental Health, 1-11.

Hu, M. X., Turner, D., Generaal, E., Bos, D., Ikram, M. K., Ikram, M. A., Cuijpers, P., & Penninx, B. (2020). Exercise interventions for the prevention of depression: A systematic review of meta-analyses. BMC public health, 20(1), 1255.

Lok, N., Lok, S., & Canbaz, M. (2017). The effect of physical activity on depressive symptoms and quality of life among elderly nursing home residents: Randomized controlled trial. Archives of gerontology and geriatrics, 70, 9298.

National Institute for Health and Care Excellence. (2009). Depression in adults: Recognition and management. Clinical guideline [CG90]. Retrieved March 13, 2021, from