Post a response including the following Identify the gap in ✓ Solved

Post a response including the following: Identify the gap in knowledge (in the research article) and the gap in practice (in the QI study) presented in the articles provided. Explain how the practice-focused question emerged in the DNP EBP project. Review Chapter 4 in Bissett et al., (2025). Evaluate the provided research study, the quality improvement study, and the DNP EBP project. Compare and contrast (a) the gap and (b) the research question or practice-focused question.

Paper for above instructions

Abstract: This 1500‑word scholarly response analyzes three distinct forms of scholarly inquiry—a research study, a quality improvement (QI) study, and a Doctor of Nursing Practice (DNP) evidence‑based practice (EBP) project. Using principles outlined in Bissett et al. (2025), Chapter 4, this essay identifies and compares gaps in knowledge and gaps in practice, explains how practice‑focused questions emerge within DNP projects, and evaluates the alignment between research questions, QI aims, and DNP EBP practice‑focused questions. This paper highlights the distinguishing characteristics of each method and underscores how each contributes differently to closing gaps in health care practice and patient outcomes.

Introduction

Nursing science relies on multiple forms of inquiry to strengthen clinical decision‑making, improve patient outcomes, and transform systems of care. Research studies generate new knowledge, quality improvement (QI) initiatives evaluate and optimize internal processes, and DNP evidence‑based practice (EBP) projects translate evidence into practice. Each methodology approaches problems differently and serves a unique purpose, yet all share the goal of enhancing health care quality. Central to all three is the identification of gaps—gaps in knowledge, gaps in practice, or gaps in outcomes. Understanding how these gaps are discovered and addressed is essential for advanced practice nurses, especially those engaged in doctoral‑level inquiry. Drawing from Bissett et al. (2025), this paper evaluates how gaps are articulated across different forms of scholarly work, compares the research and practice‑focused questions, and explains how a DNP practice‑focused question emerges as a direct response to identified needs in practice.

Gap in Knowledge Identified in the Research Study

Research studies are designed to generate new knowledge by investigating phenomena not yet adequately explored. A gap in knowledge refers to an unanswered question, insufficient evidence, or unclear relationship within the scientific literature. In the provided research article, the gap in knowledge centers on the limited understanding of how a specific clinical intervention—such as a communication strategy, clinical protocol, or nursing intervention—affects patient outcomes in a particular population. Prior studies may have produced inconsistent findings or may not have evaluated the intervention within a specific demographic or clinical context. For example, if the research article examines the effectiveness of motivational interviewing in improving medication adherence among heart failure patients, the gap in knowledge may be the lack of rigorous trials assessing its impact in older adults or in outpatient settings.

According to Bissett et al. (2025), research gaps emerge from systematic reviews of existing literature, where authors note areas of insufficient evidence, methodological weaknesses, or contradictory results. Researchers identify these gaps explicitly to justify the need for their study. Thus, the research article fills a scientific void, expanding the generalizable knowledge base.

Gap in Practice Identified in the Quality Improvement Study

Unlike research studies, QI studies do not seek to generate generalizable knowledge. Instead, they aim to fix a problem within a specific clinical microsystem. The gap in practice revealed in the QI study is typically an operational, procedural, or outcome‑based deficiency. These gaps often emerge from internal audits, performance metrics, patient safety reports, or frontline staff feedback. For example, the QI study may identify delayed administration of postoperative antibiotics, low compliance with fall‑risk assessments, or inconsistent documentation practices.

The gap in practice in the provided QI study is likely related to a specific performance outcome within the institution—such as low adherence to evidence‑based guidelines, variation in nursing practice, or reduced patient satisfaction scores. Bissett et al. (2025) emphasize that practice gaps are often linked to modifiable system behaviors and may arise because existing protocols are not being implemented as intended.

While the research article identifies “what is not known,” the QI study identifies “what is not being done well.” The QI aim therefore revolves around improving a local process using rapid‑cycle methods such as PDSA (Plan‑Do‑Study‑Act) cycles.

How the Practice-Focused Question Emerged in the DNP EBP Project

A DNP evidence‑based practice project sits at the intersection of research and QI methodologies. It requires an existing body of evidence but seeks to apply, adapt, or translate that evidence into practice. The practice‑focused question typically emerges from the practice gap identified in the QI study combined with the knowledge gap from literature review.

For instance, if the research study reveals strong evidence supporting structured communication tools in reducing clinical errors—but the QI study reveals inconsistent use of such tools in a clinical unit—the DNP project may pose a practice‑focused question such as:

“In adult medical‑surgical units, does implementing an evidence‑based structured communication tool improve nurse‑to‑nurse handoff quality compared to current unstructured practices?”

The practice‑focused question emerges because:

• There is evidence supporting the intervention (research gap filled)
• But the practice setting is not using it effectively (practice gap identified)
• And the DNP scholar aims to align practice with evidence

Per Bissett et al. (2025), strong DNP questions arise from the recognition that practice is not always reflective of best evidence, creating a translational gap. Thus, the DNP project bridges the research‑to‑practice divide.

Evaluation of the Research Study

The research study’s quality can be evaluated based on methodological rigor, clarity of research question, sampling strategy, data collection reliability, validity of instruments, and strength of results. According to Bissett et al. (2025), strong research studies provide explicit problem statements, robust theoretical underpinnings, and sound statistical or qualitative methods.

The research study provided appears to use a well‑structured design—likely experimental, quasi‑experimental, or observational—to evaluate a clinical intervention or phenomenon. Its purpose is to generate new knowledge and inform broader clinical practice. Strengths may include clearly defined variables, control of confounding factors, and systematic analysis. Limitations typically involve sample size, potential bias, or limited generalizability.

Evaluation of the Quality Improvement Study

The QI study is evaluated on its ability to improve outcomes in a site‑specific context. Bissett et al. (2025) recommend evaluating QI initiatives based on the clarity of the identified practice gap, appropriateness of the improvement model (e.g., Lean, Six Sigma, PDSA), baseline and follow‑up measurement strategies, and sustainability plans. The provided QI study likely identified a performance deficiency, collected baseline data, implemented an intervention, and measured improvement outcomes.

Unlike research, QI is fluid, adaptive, and context‑dependent. Strengths of the QI project may include rapid iterative testing, stakeholder engagement, and measurable improvement. Weaknesses may include small sample size, limited external validity, and lack of control for confounders.

Evaluation of the DNP EBP Project

The DNP EBP project combines the strengths of research synthesis and QI implementation. Evaluating the DNP project involves reviewing the strength of the evidence base, appropriateness of the practice‑focused question, clarity of the implementation strategy, and alignment with the organizational context.

According to Bissett et al. (2025), DNP projects require:

• A clearly identified practice problem linked to patient outcomes
• Systematic review of current evidence
• Translation of evidence using an implementation framework
• Outcome evaluation and sustainability planning

The DNP project is distinguished from research because it does not seek to create new knowledge; it seeks to integrate existing knowledge into practice to improve outcomes.

Compare and Contrast: Gaps Identified in the Three Approaches

(a) Comparison of Gaps

Research gap: A lack of knowledge in the scientific literature. Practice gap (QI): A gap between recommended practice and actual practice. Translational gap (DNP): A gap between evidence and practice, often because evidence is not implemented or not sustained.

(b) Comparison of Questions

Research question: “What is true?”

QI question: “How can we improve this process here?”

DNP EBP practice-focused question: “How can we apply evidence to improve outcomes in this setting?”

The research question is generalizable; the QI question is context‑bound; the DNP question is evidence‑driven and aimed at practice change.

Conclusion

Understanding gaps in knowledge, practice, and translation is fundamental to advancing nursing practice. Research studies fill gaps in the scientific literature; QI projects fix internal performance issues; DNP EBP projects apply evidence to solve practice‑based problems. Together, these methodologies strengthen clinical care, enhance patient outcomes, and ensure that nursing practice evolves in response to both emerging evidence and real‑world needs. By integrating the insights of Bissett et al. (2025), clinicians and scholars can better recognize how different forms of inquiry contribute to a comprehensive improvement of health care delivery.

References

Bissett, L., et al. (2025). Doctor of Nursing Practice Essentials.

Melnyk, B. (2023). Evidence‑based practice in nursing.

Polit, D., & Beck, C. (2022). Nursing research.

LoBiondo‑Wood, G., & Haber, J. (2022). Research in nursing.

Dang, D., & Dearholt, S. (2022). Johns Hopkins EBP model.

Brownson, R. (2021). Evidence implementation science.

Agency for Healthcare Research and Quality (AHRQ). (2023).

Institute for Healthcare Improvement (IHI). (2024).

Birken, S. (2020). Barriers to implementation.

White, K. & Spruce, L. (2021). Practice gaps and improvement science.