DNP-prepared Nurses Research Articles

Critical Appraisal of Evidence for DNP-Prepared Nurses.

This is the fourth article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making (EBDM). It builds on AJN's award-winning previous series-Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to https://links.lww.com/AJN/A133). This follow-up series on EBDM will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey. To access previous articles in this EBDM series, go to https://links.lww.com/AJN/A256.

Creating a Forum to Support DNP-Prepared Nurses and Practice Within a Children’s Hospital

Creating a Forum to Support DNP-Prepared Nurses and Practice Within a Children’s Hospital

Leveraging Doctor of Nursing Practice Scholarship to Meet Organizational Leaders' Expectations.

Background: The Doctor of Nursing Practice (DNP) degree prepares nurses for engagement in practice scholarship to improve health outcomes at multiple system levels. Organizational leaders' and employers' perceptions and expectations of DNP-prepared nurses require further study. Objective: To explore the perception of organizational leaders regarding expectations and engagement of DNP-prepared nurses in practice scholarship activities. Methods: Guided by the Actualized DNP Model, a cross-sectional design was used to survey organizational leaders (N = 87) regarding DNP-prepared nurses' engagement in practice scholarship. Results: Findings indicate that 92% (n = 80) of participants believed practice scholarship should be an expectation of DNP-prepared nurses serving in a variety of roles. Of the 77 respondents to the scholarship engagement questions, 97.4% (n = 75) reported that DNP-prepared nurses engaged in one or more practice scholarship activities over the past year. Conclusions: Aligning DNP practice scholarship competencies, as outlined in the American Association of Colleges of Nursing 2021 Essentials, with organizational needs, expectations, and provision of sufficient time to support these scholarship activities is needed. Implications for Nursing: Opportunities exist for DNP-prepared nurses to articulate and demonstrate their value by conducting practice scholarship through innovative advanced nursing roles to realize organizational goals. Organizational support is necessary for practice scholarship activities to transform DNP education.

DNP-Authored Articles in Peer-Reviewed Journals 2011-2021.

With an increasing number of doctor of nursing practice (DNP) graduates, the volume of peer-reviewed journal publications among DNP-prepared nurses is rising. The primary aim of this study was to quantify, analyze, and categorize DNP-authored peer-reviewed journal publications. A descriptive research design was used to analyze DNP-authored peer-reviewed journal publications in the WorldCat, EBSCO Discovery Service, and PubMed databases from 2011 through 2021. The 3839 journal publications included at least one DNP-prepared nurse author. There were 2495 (65%) publications with a DNP first author, 921 (24%) with a DNP solo author, and 2918 (76%) included publication collaboration. The majority of publications were practice- (40%), nursing- (17%), and education-focused (15%). Science translation in evidence-based practice and quality improvement publications accounted for 24%. This study demonstrates the proliferation of DNP-authored peer-reviewed journal publications, which may indicate an increase in the number of nursing care quality initiatives occurring in the clinical setting.

National evaluation of DNP students' use of the PICOT method for formulating clinical questions.

The intent of the PICOT (i.e., Population, Intervention, Comparison, Outcome, Time) method is to formulate focused clinical questions to facilitate the discovery of relevant evidence through systematic searching, with the components of the question serving as the foundation for the search. Doctor of Nursing Practice (DNP) graduates use evidence-based practices to institute changes in their organizations' systems and policies, thereby yielding positive effects on both patient and system outcomes. Given that the clinical question is the foundation of the evidence-based practice process, DNP graduates' competence in the PICOT method needs to be better understood. This analysis aimed to describe how DNP students used the PICOT method to ask clinical questions in their DNP projects. Project questions were retrieved from a subset (n = 129, 60.56%) of an existing national random sample of publicly available DNP projects spanning the years 2010 to 2021 from Commission on Collegiate Nursing Education-accredited schools (n = 213). Project questions using the PICOT method were further evaluated with a scoring system of 0 = no and 1 = yes for missing elements, formatting, directional outcome, and project purpose. Possible scores ranged from 0 to 8, with higher scores indicating more errors. Discussion among five researchers, until agreement was achieved, yielded consensus. Although the PICOT method was project author-identified in 66 (31.0%) projects, only four (6%) followed the PICOT method. All 66 (100%) were intervention questions. There were 2.74 (SD 1.55) mean errors, ranging from 0 to 6. No questions were missing P or O. Specific errors included missing I 3 (4.5%) or missing C 37 (56%), poor formatting 34 (51.5%), directional outcome 44 (66.7%), and project purpose 38 (57.6%). Thirty-three (50%) of the questions were missing T; however, T is not used for searching, so researchers recalculated the mean error without T (M = 2.24, SD = 1.28, range 0-5). Gaps in the accurate use of the PICOT method to construct clinical questions can lead to biased searches, inaccurate clinical problem identification, and, when used as the project purpose, jumping to non-evidence-based solutions. Academic faculty and clinical educators can mitigate these skewed outcomes and enhance their impact on quality outcomes by helping DNP-prepared nurses shore up this foundational skill.

Practice scholarship satisfaction and impact as perceived by DNP-prepared nurses.

Today's health systems are complex and are challenged to strive for high-quality care that leads to optimal health outcomes. Doctor of Nursing Practice (DNP)-prepared nurses have the necessary competencies to influence health systems and delivery, that lead to safe and effective practice, by implementing practice scholarship, the translation of science to transform health care delivery, and clinical inquiry to improve practice. The purpose of this study was to determine DNP-prepared nurses' satisfaction with their frequency of engagement in practice scholarship, and the relationship between the satisfaction and perceived impact of practice scholarship. In this cross-sectional study, DNP-prepared nurses (n = 309) were recruited from a U.S. national membership organization and were asked to complete an online survey. Usable data findings (n = 269) revealed that 81% of participants reported feeling very, or moderately, satisfied with time spent engaging in practice scholarship or clinical inquiry in the areas of quality improvement, translation of research, and evidence-based practice; however, 19% expressed minimal satisfaction or dissatisfaction. There was a significant, moderate positive correlation between impact and satisfaction with time spent engaging in practice scholarship. Unclear roles and the lack of objective data measurement of practice scholarship are hindering the ability of DNP-prepared nurses to work to the full extent of their education and scope of practice. Further studies to develop processes and tools to measure the value and impact of DNP-prepared nurses on quality and safety, health care policies, systems, and population health are recommended.

Impact of Practice Scholarship as Perceived by Nurses Holding a DNP Degree.

The aim of this study was to explore the perceived impact of practice scholarship among DNP-prepared nurses and the relationship of impact to primary work role and years since graduation. Healthcare organizations continuously seek ways to improve health outcomes and reduce cost. Doctor of Nursing Practice-prepared nurses are educated with essential competencies to lead healthcare reform initiatives based on their practice scholarship contribution. A cross-sectional design was used to administer a self-report online survey to a convenience sample of 306 DNP graduates currently in practice. The highest impact of practice scholarship was perceived on patients, populations, quality of care, and the profession. The impact on policy, cost, and cost savings was significantly lower. No significant difference was found on practice scholarship impact based on role or between years of experience since graduation. Doctor of Nursing Practice competencies support practice scholarship outcomes. Organizational resources are needed to support the impact of practice scholarship.

Practice scholarship engagement as reported by nurses holding a doctor of nursing practice degree.

Nearly 15 years after the introduction of the doctor of nursing practice (DNP) degree, stakeholders anticipate practice scholarship outcomes from graduates. To examine the frequency of engagement in practice scholarship, the relationship between the knowledge gained in DNP programs and the frequency of engagement in practice scholarship and the relationship between engagement in practice scholarship, work role, and years since graduation with a DNP degree, as reported by practicing nurses. This cross-sectional study recruited 306 practicing DNP graduates via a national organization and employed an electronic survey. Descriptive and inferential statistics, correlational analysis, and a one-way analysis of variance were conducted on demographics and outcome variables for 269 completed surveys. The practice scholarship activity reported most frequently was evaluation of current clinical evidence and least frequently was dissemination of policy papers. Reported knowledge gained from DNP programs and frequency of engagement in practice scholarship indicate a weak positive correlation. There was a significant difference in the direct care work role and practice scholarship engagement compared with other roles, and between those practicing greater than 10 years and those with less experience. Results highlight the underutilization of knowledge gained in DNP programs and engagement in practice scholarship. The study emphasizes the complexity of realizing practice scholarship outcomes of DNP-prepared nurses to influence patients, populations, systems, and policy as well as the advancement of the nursing profession. This is a call to action for DNP graduates, academia, practice, and the nursing profession to support and value practice scholarship.

Drivers for seeking the doctor of nursing practice degree and competencies acquired as reported by nurses in practice.

The American Association of Colleges of Nursing introduced the Doctor of Nursing Practice (DNP) degree in 2004. To date, few publications examine the competencies and impact of nurses with practice doctorates. The purpose of this study was to examine reasons for seeking a DNP degree, assess knowledge and competencies acquired from DNP programs, and to inform stakeholders about the skills acquired by nurses with practice doctorates. A cross-sectional design was used to administer a self-report survey to a convenience sample of DNP-prepared nurses in practice, recruited from a national membership organization. The electronic survey was designed using constructs developed from the literature, national organization position statements, and standards of doctoral nursing education. A total of 306 participants responded to the survey, 270 were used after data review. The majority of respondents did not seek a DNP degree because it was required for a job, to gain additional supervised practice, or to receive additional training with a specialty population. The majority strongly agreed that they gained competency in translating and synthesizing research evidence into practice, designing and implementing quality improvement, and identifying, measuring, and evaluating outcomes. Primary reasons for seeking a DNP degree were seeking knowledge, skills, competencies, confidence, and job opportunities. Doctor of Nursing Practice-prepared nurses hold unique, advanced knowledge, competencies and skills to affect health care across multiple settings. Study results suggest that highly skilled DNP-prepared nurses are equipped to lead quality improvement, engage in practice scholarship, and improve clinical outcomes.

Students' Perceptions of the Value of Learning the Skill Sets of a DNP-Prepared Nurse: An Exploratory Study.

Students enter doctor of nursing practice (DNP) programs with varying interests and professional experiences. Little is known about how this impacts learning. To explore if differences existed in students' perceptions of task values related to learning the skill sets of a DNP-prepared nurse. Students were sent a link to a 17-item electronic survey consisting of demographic questions and nine statements based on competencies as outlined in The Essentials of Doctoral Education for Advanced Nursing Practice (American Association of Colleges of Nursing [AACN], 2006). Students ranked the statements in order of perceived value of performing after program completion. Mean rankings of task values demonstrated the advanced practice registered nurse (APRN) group (n = 32) identified the most valuable skill as "suggest an evidence-based change in professional practice based on the findings of published research articles and professional practice experience." The non-APRN group (n = 10) reported "work collaboratively with other non-nursing healthcare professionals to improve patient and population health outcomes." Students' perceptions of the value of learning the skill sets vary amongst APRNs and non-APRNs, and are shaped by past professional experiences and future role demands. Findings provide faculty with knowledge that can be used to tailor teaching and engagement strategies.

Describing the Challenges Faced by Newly Prepared DNP Graduates in the Acute Care Setting

Since the development and introduction of the doctor of nursing practice (DNP) degree in 2004, the number of doctoral-prepared nurses has increased dramatically. The purpose of this article is to review the current challenges faced by DNP-prepared nurses as they enter the acute health care setting, and to share strategies we are exploring to enhance and showcase DNP practices and outcomes. In collaboration with our doctor of philosophy nursing colleagues, it is critical that we conduct studies that document the impact that DNP graduates have on health care organizations and, most importantly, patient outcomes. Since the development and introduction of the doctor of nursing practice (DNP) degree in 2004, the number of doctoral-prepared nurses has increased dramatically. The purpose of this article is to review the current challenges faced by DNP-prepared nurses as they enter the acute health care setting, and to share strategies we are exploring to enhance and showcase DNP practices and outcomes. In collaboration with our doctor of philosophy nursing colleagues, it is critical that we conduct studies that document the impact that DNP graduates have on health care organizations and, most importantly, patient outcomes. Ruth Labardee, DNP, RN, CNL, NEA-BC, is the director of health system nursing quality and evidence-based practice at The Ohio State University Wexner Medical Center (OSUWMC) in Columbus, Ohio, and assistant professor of clinical practice at The Ohio State University College of Nursing. She can be reached at [email protected] Jacalyn Buck, PhD, RN, NEA-BC, FAONL, is the chief nursing officer at University Hospital, Ross Heart Hospital, Brain and Spine Hospital and Dodd Rehabilitation Hospital at OSUWMC, and assistant professor of clinical practice at The Ohio State University College of Nursing. Rebecca Coffey, PhD, MSN, CNP, is a nurse practitioner for the Burn Center at OSUWMC. Kerry Dhakal, MAA, MLS, is an assistant professor, and research and education librarian at The Ohio State University. Deborah Francis, DNP, RN-BC, APRN-CNS, is a medical surgical clinical nurse specialist at OSUWMC. Deborah Seeling, DNP, RN, APRN-CNP, FNP-C, is a family nurse practitioner at The Ohio State University Hospital East, and an assistant professor of clinical practice at The Ohio State University College of Nursing. Esther Chipps, PhD, RN, NEA-BC, is a nurse scientist at OSUWMC and associate professor of clinical nursing at The Ohio State University College of Nursing.

The role of Doctor of Nursing Practice-prepared nurses in practice settings

BackgroundThe role of the Doctor of Nursing Practice-prepared nurse (DNP) outside of academic settings has not been clearly articulated or widely explored, and therefore the value DNP-prepared nurses bring to their practice settings is largely unknown. This study: (1) surveyed existing DNP programs to identify the nonacademic settings in which their DNP graduates were employed and (2) conducted semistructured interviews with employers to identify the role and value of the DNP-prepared nurse in nonacademic settings. MethodData were collected from January 2016 to August 2016 in two parts: (1) an online survey of the DNP programs and (2) qualitative semistructured telephone interviews with employers. First, we conducted an online survey of program directors (or their equivalent) from 288 DNP programs across the United States to capture descriptive information about current DNP programs (e.g., location, modality, profit status), the types of nonacademic institutions that hire their graduates, percentage of graduates employed by each setting, and the contact information for these employers. Employers were identified either by DNP program directors through the online survey or by a convenience sampling method. Using semistructured telephone interviews, we asked questions to employers in different care settings about the role of the DNP in these settings and how the DNP compares to other nurse leaders and advanced practice nurses (APRN). Employers were asked to describe the role of the DNP-prepared nurse working in direct patient care roles such as APRNs or as leaders, administrators, and managers. FindingsDescriptive thematic analyses were derived from the interviews, to identify the roles DNP-prepared nurses filled and how they compared to other nurse leaders and advanced practice nurses in these settings. A total of 130 DNP program directors responded to the online survey. Twenty-three employers participated in semistructured telephone interviews. The thematic analysis resulted in four main themes regarding the role of the DNP-prepared nurse in non-academic settings: “DNP-Prepared Nurse Positions and Roles,” “Perceived Impact of the DNP-Prepared Nurse on Staff, Patient, and Organizational Outcomes,” “Comparison of the DNP-Prepared Nurse to Other Nurses With Advanced Training,” and “Challenges Experienced by Nurses With DNP Degrees. DiscussionThe role of the DNP-prepared nurse in nonacademic settings is unclear. These DNP-prepared nurses typically function as APRNs in clinical care or as health care system leaders. While there is a low number of DNPs in clinical practice settings, the number is expected to grow as more graduate and enter practice. Thus, knowledge of the roles, value, and outcomes of the DNP-prepared nurse can guide practice setting leaders on how to best use DNP-prepared nurses in their setting.

Examining the Roles and Competencies of Nurse Leaders, Educators, and Clinicians With a Doctor of Nursing Practice at an Academic Medical Center.

As the nursing profession has gained experience with Doctor of Nursing Practice (DNP) graduates, it is important to examine the integration, operationalization, and contributions of the DNP-prepared nurse within healthcare systems. Administrators and leaders must have a clear vision of how DNP graduates will contribute within and outside of their organizations. This article describes the outcomes of a workgroup comprised of DNP-prepared staff at a large academic medical center. The overarching goal of this group was to examine current practices of our DNP-prepared staff and make recommendations regarding roles and practice to the senior nursing leadership. A crosswalk comparing the current job descriptions of our DNP-prepared nurse leaders, nurse practitioners, clinical nurse specialists, and nurse educators with the core competencies of The Essentials of Doctoral Education for Advanced Nursing Practice as outlined by the American Association of Colleges of Nursing was completed. Strategies and tactics to enrich current practice and build leadership capacity were identified. DNP-prepared nurses must continue to document their contributions to the healthcare setting. DNP-prepared nurses in the health-care setting must work collaboratively with their senior nursing leaders to seek opportunities to increase their visibility within their organizations, and increase their scholarly output.

Exploring the Experiences of DNP-Prepared Nurses Enrolled in a DNP-to-PhD Pathway Program

The advancement of the doctor of nursing practice (DNP) degree and the need for nurse researchers with a doctor of philosophy (PhD) has led to significant growth in doctoral nursing education. Some DNP graduates have chosen to pursue a second terminal degree. This descriptive study explored the experiences of students completing a DNP-to-PhD pathway program. Data analysis revealed that DNP-to-PhD students desired acceptance in academia. Implications suggest the need for additional pathway programs, clear communication about program outcomes for both degrees, formal teaching preparation for all nurse educators, and collaborative opportunities for DNP- and PhD-prepared faculty.

Advancing the Rigor of DNP Projects for Practice Excellence

Over a decade has passed since the Institute of Medicine1 first called for a restructuring of how health care professionals are educated. Since then significant changes have occurred, including the creation of the Doctor of Nursing Practice (DNP) degree focused on scholarly practice rather than research. In the context of an increasingly complex health care system and declining health outcomes in the United States, DNP graduates are prepared to practice at the most advanced level of nursing by synthesizing, translating, and applying the most sophisticated evidence into clinical practice. The attributes of the DNP-prepared nurses could not be more important as executive leaders contend with the demand for value-based health care. There is a critical need for leaders to be grounded in innovation science in order to meet the challenges of sustainable redesign.

DNP-Prepared Nurse Leaders: Part of the Solution to the Growing Faculty Shortage: Erratum

DNP-Prepared Nurse Leaders: Part of the Solution to the Growing Faculty Shortage: Erratum

DNP-Prepared Nurse Leaders: Part of the Solution to the Growing Faculty Shortage.

It is no secret that there is a nursing faculty shortage due to aging faculty, retention issues, and an increased need for more nurses with the DNP degree. This parallels the ongoing nursing shortage, as lack of faculty limits nursing student capacity. Explanation of how DNP-prepared faculty can help fill the nursing faculty shortage and strategies are explored in this article.

Assessing DNP impact using program evaluations to capture healthcare system change.

The doctor of nursing practice (DNP) degree was formalized in 2004. Data evaluating the impact of DNP-prepared nurses on individual patient care, population health, and healthcare system outcomes are limited. This article demonstrates how the DNP Essentials can be used to frame DNP program evaluation data.

The DNP: Degree or Role?

IN MY OPINION Kahlil Demonbreun, DNP, WHNP-BC The nurse practitioner’s role garners much positive attention on a daily basis for a variety of educational, political, and professional reasons. For example, a recent report indicated an unprecedented demand for nurse practitioners (NPs) over the past 2 years. The report cited a 320% increase according to a Merritt Hawkins study that observed the company’s number of search assignments to fill NP positions. The minimum educational preparation required for licensure is the master’s degree. However debate exists on transitioning this minimum to the doctor of nursing practice (DNP) degree. Adding to the attention, there is exponential growth in the number of nurses earning the DNP degree. What can be confusing is that not all nurses who earn the DNP degree are NPs. Still, with such growth, questions on how best to utilize the unique skill set of DNPprepared nurses continue to emerge. In providing focus for this topic, one report echoed the concerns of many health care professionals by questioning what is to be done with these DNPs. Apparently “the jury is still out” based on several recent studies suggesting: 1. Employers are unclear about the differences between master’s-prepared and DNPprepared advanced practice registered nurses and could benefit from information on outcomes connected to DNP practice. 2. Gaps exist in chief nursing officers’ knowledge about the expectations, competencies, and projected outcomes of DNP-prepared nurses. 3. Failures to fully grasp that DNP-prepared nurses can fill a broad range of roles. 4. Issues of confusion about DNP-prepared nurses indicating a need for them to articulate what they offer above and beyond that of a master’s of science in nursing (MSN)‒prepared nurse. Although exploration of these and similar questions will contribute to an evolving evidenced-based foundation addressing the

DNP and PhD Collaboration: Bringing Together Practice and Research Expertise as Predegree and Postdegree Scholars.

A deliberate course of predegree intraprofessional DNP and PhD student collaboration can yield relationships that will facilitate postdegree teamwork. Working together, DNP-prepared nurses can use their practice expertise, and PhD-prepared nurses can use their research expertise to improve and change health care. This article presents 3 contexts in which predegree collaboration can occur between DNP and PhD students. Postdegree DNP and PhD collaboration can occur in 2 contexts.