DNP 7700

_MRU-DNPPICOTFORMreview2026.docx

PICOT FORM

To be completed by students and submitted during the course DNP 8000 in Moodle week #3 - 90 days before their first practicum course DNP 7700. The PICOT question must be approved by Dr. Gonzalez and Dr. Dionne. Once the form is approved and signed, the student must submit the approved form in the course DNP 8000 week #6. Failure to submit this form and all required information in a timely manner may result in the inability to register for DNP-7700 for the desired session.

These forms are typeable, handwritten forms will not be accepted.

Student information

Student Name: Vladimir Andino Alonso

Email: [email protected]

Address: 2974 NW 29 St Miami FL 33142

Student ID: VA-7575

Phone:786-616-6023

1. What is the practice issue (foreground?)

The lack of standardized implementation of Enhanced Recovery After Surgery (ERAS) protocols in adult abdominal surgical patients leads to increased postoperative complications, prolonged length of stay (LOS), delayed recovery, and higher healthcare costs. Despite strong evidence supporting ERAS pathways, variability in clinical practice and inconsistent adherence to evidence-based perioperative care remain significant barriers.

This practice issue reflects a gap between current evidence and clinical practice, aligning with DNP Essential I (Scientific Underpinnings) and Essential III (Clinical Scholarship and Analytical Methods).

Impact on Patient Care Outcomes

1. Reduction in postoperative complications (ileus, DVT’s. etc)

2. Accelerated recovery and functional status.

3. Improved pain management and patient experience.

Impact on Organizational Outcomes

1. Reduced length of stay (LOS) and throughput optimization.

2. Cost reduction and value-based performance.

3. Standardization of care and reduction in practice variability.

2. What is the practice area?

Administration: Yes _x__ No___

Clinical: Yes x___ No___

Educational administration: Yes ___ No ___x__

Informatics: Yes _x__ No ___

Policy: Yes __x_ No ___

Organization philosophy or mission and vision statement:

Deliver high-quality, patient-centered, evidence-based care that improves outcomes and reduces costs.

3. How was the practice issue identified? (check all that apply)

Quality and safety/risk management: Yes _x__ No ____

Significant financial concerns: Yes __x__ No _____

Procedural or process issue: Yes __x__ No ____

Unsatisfactory patient outcomes: Yes __x__ No ______

Different between hospital and community practice: Yes __x___ No _____

Other (define in space below): Yes ____ No __x___

Wide variation in practice: Yes __x___ No _____

Clinical practice issue: Yes __x__ No _____

4. How will the project align with institution mission?

The ERAS project supports the institution’s mission by:

· Promoting evidence-based, standardized care

· Improving patient outcomes and satisfaction

· Reducing healthcare costs and LOS

· Enhancing interdisciplinary collaboration

This aligns with:

· DNP Essential II (Organizational leadership)

· DNP Essential VI (Interprofessional collaboration)

Does your project align with the site business models?

Implementation of ERAS will:

· Reduce length of stay (LOS) → improves bed turnover and capacity

· Decrease complications and readmissions → reduces financial penalties

· Improve cost-efficiency → aligns with value-based care models

· Support quality metrics and reimbursement incentives (CMS, value-based purchasing)

This reflects systems thinking and financial stewardship (DNP Essential II).

6. What is the scope of the problem?

Family: Yes ___ No _x__

Individual: Yes _x__ No ___

Institution/system: Yes _x__ No ___

Population: Yes _x__ No ___

Other (define in space below): The problem affects:

· Individual patients (delayed recovery, complications)

· Healthcare systems (cost burden, inefficiency)

· Population outcomes (variation in surgical recovery standards)

7. What are the PICOT elements?

Quantitative (PICOT)

Population: Nurses taking care of adults patients undergoing elective abdominal surgery a 9 north.

Intervention: Implementation of ERAS protocol

Comparison: Standard perioperative care

Outcome: Reduced length of stay, decreased complications, improved recovery

Timeframe: 8 weeks

8. What evidence must be gathered? (check all that apply)

Integrative Literature review: Yes __x__ No ___

Guidelines: Yes _x__ No ___

Clinical Expertise: Yes __x_ No ___

Systematic Literature review: Yes __x__ No ____

Expert opinion: Yes __x__ No ____

Financial analysis: Yes _x__ No ___

Standards (regulatory, professional, community): Yes __x_ No ___

Patient preferences: Yes _x__ No ___

Other (define in space below): Yes _x__ No __

· Hospital quality dashboards

· LOS and complication baseline data

· Cost-analysis reports

9. State the PICOT question in narrow manageable terms.

In registered nurses caring for adult patients undergoing robotic assisted radical cystectomy surgery, how does the implementation of a structured ERAS education program affect adherence to ERAS protocols post operatively while inpatient in a 8 weeks time phrame?

References

Gustafsson, U. O., Scott, M. J., Hubner, M., Nygren, J., Demartines, N., Francis, N., Rockall, T. A., Young-Fadok, T. M., & Ljungqvist, O. (2025). Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. Surgery.

Association of periOperative Registered Nurses. (2025). Enhanced recovery after surgery (ERAS) guideline.

Wagoner, C. W., Jackson, R. S., & Holsinger, F. C. (2025). Enhanced recovery after surgery compliance and postoperative outcomes. JAMA Otolaryngology–Head & Neck Surgery.

Sauro, K. M., McIsaac, D. I., Wijeysundera, D. N., & Bryson, G. L. (2024). Enhanced recovery after surgery guidelines and hospital outcomes: A systematic review. JAMA Network Open, 7(1), e2356789.

Grant, M. C., Isada, T., Ruzankin, P., Whitlock, E. L., & Ahuja, N. (2025). Enhanced recovery after surgery: Overarching themes of ERAS Society guideline updates. Anesthesia & Analgesia.

Student’s Name: Vladimir Andino Alonso

PICOT Question Approved Yes _____ No _____

____________________________________________________

Course DNP8000 Professor

__________________________________________________

Associate Dean DNP program

DNP 7700

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