Modifications Needed: Additional Strategies to Transform DNP Projects into Publishable Manuscripts

Abstract

Since the Doctor of Nursing Practice (DNP) degree was introduced by the American Association of Colleges of Nursing (AACN) in 2004, 348 programs have been established with more than 32,000 students enrolled.1, 2 As a practice-focused doctorate, DNP programs prepare graduates to enhance health outcomes through the critical appraisal and application of scientific findings. This goal is achieved through evidence-based practice (EBP) and quality improvement (QI) initiatives, many of which will make significant contributions to the nursing literature by addressing gaps in practice. However, Rousch and Tesoro4 investigated the rigor of DNP projects and identified some substantive problems including unsupported conclusions, lack of data collection, and flawed methodology, among others. So, how can authors, faculty, advisors, reviewers, and editors ensure that quality DNP projects are published? This article offers practical strategies to assist graduates in transforming a scholarly academic project into a manuscript appropriate for publication in a peer-reviewed journal. Faculty and advisors often encourage graduates to publish their work. At first glance, transforming an academic project into an appropriate publication for a peer-reviewed journal may seem like an easy feat. However, there are key differences between academic papers and quality manuscripts ready for publication that authors must consider. Academic papers, such as DNP student projects, are written to satisfy course or program requirements. These works meet specific assignment guidelines and are evaluated with course/program rubrics. Conversely, publishable manuscripts have a narrow focus, are targeted to a specific journal, and present new information or a new perspective about a particular topic and are intended to improve practice. These manuscripts are reviewed by professionals in the discipline and must meet established journal criteria. Table 1 provides some other key differences between academic papers and journal manuscripts that authors should consider. As DNP projects primarily represent EBP and QI activities, it is important to understand the common frameworks frequently used by journals when reporting QI initiatives and use them to guide manuscript development. For consistency and quality across disciplines, most healthcare journals require that authors use reporting guidelines recommended by the EQUATOR Network.3 The EQUATOR Network is an organization of editors and researchers, among others, who have identified reporting guidelines for various study types that can assist to increase accuracy, completeness, and transparency when reporting about health topics.3 Recognizing that DNP projects are primarily EBP and QI initiatives, the EQUATOR Network recommends that these initiatives be reported using the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0.5 The SQUIRE 2.0 guidelines include 18 sections that describe why the initiative was implemented (introduction), what was done (methods), what was identified (results), and what the results mean (discussion). Click here to read a downloadable table that includes all 18 elements with descriptions of each item. Many DNP programs have embraced the SQUIRE 2.0 guidelines for student reporting of their work so you may be familiar with this document. Either way, using the SQUIRE 2.0 guidelines may ease the transformation of an academic paper into a publishable manuscript. Authors should follow the advice previously published in the literature that offers traditional strategies for publication success. Many helpful articles have been published in Nurse Author & Editor and provide further assistance with these writing basics. There are several other practical strategies that DNP graduates can use to possibly increase the likelihood of publication. The first step is to identify an appropriate journal for QI or EBP projects. To do so, think about the topic and journals that are related to your specialty. For example, nurse practitioners may consider submitting a manuscript to The Journal for Nurse Practitioners while a nurse leader may consider submitting a manuscript to the Journal for Healthcare Quality. It is also helpful to identify journals that embrace EBP and QI articles. The SQUIRE 2.0 website provides a non-encompassing list of journals and serves as a good starting point for possible journals to consider. Reviewing one's own DNP project reference list may further identify potential publication options. As with the preparation of any manuscript, it is essential to review the author and manuscript guidelines for selected journals. Some authors find it useful to print the author and manuscript guidelines to use as a reference while writing and use it as a checklist before submitting an article. The next strategy for transforming an academic paper into a publishable manuscript involves reviewing manuscripts in the selected target journals to get a sense of the format and approach used for these types of projects. This valuable step will provide examples of how to present information, section length, headings, format, and overall manuscript length. As you begin writing and editing consider items that you may need to modify from the original project. In general, manuscripts submitted for publication have much shorter literature reviews than academic papers may require. So, think about what are the essential references that contribute to the article. As you transform the academic paper, consider what was unique about the project? What new information was gleaned? Think about why readers will be interested in the topic and why this is important to share. What are the main takeaway points from your manuscript? Incorporate these answers into your writing. When describing the project, make sure that you have provided sufficient details about the rationale, problem, and methods. Thoroughly describe the impetus for your project and the specific intervention(s) so that readers can understand what was done and can replicate your work. When discussing the findings, it is helpful to present baseline data, evaluation metrics, and how the intervention influenced patient outcomes or organizational effectiveness. You should also address pertinent barriers, facilitators, financial considerations, plans for project sustainability, and lessons learned. Writing clearly and succinctly can be a challenge for many writers. One effective strategy to overcome this challenge is to utilize the SQUIRE 2.0 checklist while writing. This checklist provides a framework for each of the 18 SQUIRE 2.0 sections. You may also find it helpful to have someone outside of your specialty read your work and provide feedback utilizing the SQUIRE 2.0 checklist. This external review can provide valuable insight on the overall flow, presentation of crucial information, and implications for nursing practice while also ensuring that all key SQUIRE 2.0 components are addressed. It pains us to say this, but we would be remiss if we did not include this piece of advice: not every project meets a standard necessary for publication in a journal. Sometimes the number of people who participated in the project is too small to draw meaningful conclusions or the impact of the initiative is too specific to the local setting to be of interest to a wider audience. You need to be honest with yourself on this point, or heed the advice of mentors or colleagues, who are perhaps telling you something you don't really want to hear. Rather than spending a lot of time pursuing publication unsuccessfully, it might be wiser to begin work on your next project, thinking carefully about what you need to do to make the project a success with outcomes that will merit publication. When DNP scholarly projects such as QI and EBP initiatives are successfully converted into publishable manuscripts, they can offer journal readers useful information that can advance nursing practice. However, these manuscripts need to follow the appropriate format for reporting and meet publication standards. Using the guidelines provided above should assist students and graduates to convert their academic projects into works that may be suitable for publication. Aaron M. Sebach PhD, DNP, MBA, AGACNP-BC, FNP-BC, FHM is an Associate Professor and the Doctor of Nursing Practice Program Chair in the College of Health Professions at Wilmington University, New Castle, DE. He is an experienced nurse practitioner and educator. He regularly presents and publishes content related to the Doctor of Nursing Practice degree. Contact Aaron by email: aaron.m.sebach@wilmu.edu Teresa Shellenbarger PhD, RN, CNE, CNEcI, ANEF is a Distinguished University Professor and the Doctoral Program Coordinator in the Department of Nursing and Allied Health Professions at Indiana University of Pennsylvania, Indiana, PA. She is an experienced nurse educator and author. She currently serves as an Author-In-Residence for Nurse Author & Editor and regularly contributes articles about writing. Contact Teresa by email: tshell@iup.edu.