To prepare an OUTLINE for a DNP project that presents all the components of a qualitative approach to studying my phenomenon of interest [My proposed PICOT question : In postpartum, women undergoing either vaginal or cesarean delivery (P), does hourly rounding and use of whiteboard (I), compared to no rounding and no use of whiteboard (C), increase patient satisfaction with pain management (O) in a 3-month trial period (T)?] .

 The American Association of Nursing defines nursing as: “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.
• Nursing knowledge requires a continuing process of research and education.
• As a profession, nurses hold a significant responsibility to keep knowledge of evidence based practice up to date proactively.
• In obtaining this knowledge the nurse is then able to apply it to his or her nursing practice.
• As a profession, in order to be successful in the nursing field one must desire and take responsibility to expand their knowledge through continuous fervent reading and interpretation of research in order to advance their nursing practice.
• The next step requires the nurse to take what they learn and share it with their fellow co-workers and leadership in order to make a suggestion for change that may impact the units nursing practice for the better.
• Through incessant implementation of updates in evidence based practice the unit is able to function offering the highest quality and safest care possible.
• The focus needs to be on a continual striving for clinical excellence.
Hourly roundings
• Nurse rounding in the United States (US) is a structured, intentional process in which the nurse checks “ 4P” -the patient’s pain, personal needs (toilet requirements), position (comfort) and possessions (drinks and glasses, plus whether the call bell, or call light, is within reach) (Meade et al 2006).
• The process of rounding as a timed, planned intervention by nursing staff to address specific elements of nursing care for patients was seen proactively to seek to identify and meet patients’ fundamental care needs and psychological safety (Meade et al 2006).
• Intentionally checking on patients at regular intervals, known more colloquially as hourly rounding, has been suggested as a primary mechanism to address basic patient needs as well as enhance patient safety and experience.
• The acronym “I CARE” ( introduce, comfort, ask, review and exit) is often used for hourly roundings.
• The practice of proactive and regular checks of hospitalized patients to decrease patient anxiety has been included in nursing curricula since the mid-1970s, although not tested in formal trials.
Rounding process
• Rounding is a defined process of care delivery, including checklists and protocols for nurses to follow, as well as guidance and documentation as to who performs rounds and how often. The recommended frequency of rounding varies, and it is most