DNP Projects Research Articles

Student-led Doctor of Nursing Practice projects in the clinical environment: Viewpoint from hospital-based nurse scientists and leaders

BackgroundExponential increases in DNP program enrollment have come with a rapid rise in the number of capstone projects conducted in clinical environments. However, misaligned priorities between students, faculty, and clinician leaders have created significant challenges. PurposeIdentify opportunities to strengthen collaboration between academic and clinical stakeholders to better support DNP projects and education. MethodExperienced hospital-based nurse leaders engaged in scholarly discourse supplemented by policy and research in DNP education. FindingsFacilitating a DNP project requires significant investment of time, resources, and funds from the healthcare institution. Discord has arisen due to unclear responsibilities or decision-making ability for clinical stakeholders, ethical dilemmas for students who are also employees of the clinical site, and mismatched priorities between clinical need and student/academic project desires. Clinical leaders have raised significant concerns about DNP project proposals that are research-focused, diverge from healthcare institution goals, and lack a sustainability plan. DiscussionFortification of academic-practice partnerships and clarification of roles in the DNP student project are necessary to ensure that the project is of educational value to the student, a demonstration of learning for faculty, and of sustained clinical value to the healthcare system.

Enhancing Organizational Review and Promoting Sustainability of DNP Student Projects: Implications for Nurse Leaders.

This project aimed to evaluate the DNP projects at an academic medical center, assess the sustainability of DNP final projects, and explore potential opportunities to enhance the organizational review processes. The organization's graduate student review committee reviewed DNP projects implemented at the organization over the last 8 years. The sustainability of projects was less than anticipated. Recommendations are provided to enhance the DNP project approval process and improve strategies for sustainability.

Transforming DNP Projects: Navigating Success With Project Management Tools in Nursing Education.

Transforming DNP Projects: Navigating Success With Project Management Tools in Nursing Education.

The Ongoing Conundrum About DNP Project Variability

An important publication titled The State of Doctor of Nursing Practice Education in 2022 reports on a national study that examined the current state of DNP graduates both in practice and in academia. The key findings, conclusions, and recommendations of the 2022 report provide an updated snapshot of current DNP education and practice along with recommendations for curricula and utilization of DNP graduates. This article focuses on the DNP Project as an integral component of the DNP curriculum in developing clinical leaders and scholars to improve healthcare outcomes and significantly impact healthcare transformation. Many publications have addressed the significant variability of the DNP Project among programs. This AACN report further underscores variability among DNP Projects regarding purpose, focus, format, development, evaluation, dissemination, and contribution to practice. The purpose of this article is to provide a perspective for nurse leaders and faculty about selected key findings, conclusions, and recommendations from this 2022 report that relate to DNP Projects as a means to improve the value and rigor of DNP Projects and decrease the variability among DNP programs.

National evaluation of DNP projects based on 2015 AACN white paper and 2019 DNP project roadmap.

The AACN expectation to prepare DNP graduates with EBP and QI competencies using the project was clarified with the 2015 White Paper and these expectations have not changed with the new Essentials. Evidence suggests DNP projects continue to be a mix of research and QI. Using the DNP Project Roadmap, we reviewed 214 projects from 120 schools from publicly available sources for the presence of EBP and QI project elements. Of the 27 Roadmap elements evaluated, only two had a significant (p≤.05) positive change after the release of the White Paper 1) a question to frame the problem/issue (pre-48.4 %, n = 45, post-64.5 %, n = 78) and 2) an evidence search (pre-26.9 %, n = 25, post-39.7 %, n = 48). Nineteen of the 27 elements had positive change; however, were still not present in >50% of the project papers. These findings can be used to engage in a national conversation on DNP curricular expectations of projects that demonstrate student competency in EBP and QI.

Strategies for developing faculty confidence and competencies to mentor quality improvement DNP projects.

DNP faculty who mentor students in quality improvement (QI) DNP projects often lack essential knowledge of QI principles. The purpose of this article is to guide DNP programs in developing confident and competent faculty mentors for QI DNP projects, facilitating DNP student success. At a multi-campus practice- and research-intensive university, strategies employed to teach College of Nursing faculty essential knowledge of QI principles comprise structural and process components. Structural supports standardize faculty workload, promote potential for collaborative scholarship, and provide instructional and resource support for faculty mentors. Organizational processes facilitate identification of practice sites and meaningful projects. A College of Nursing and university Institutional Review Board collaboration established policy to guide human subjects protection regarding DNP project activity, streamlining and standardizing the process. Library support mechanisms, access to ongoing faculty QI training and resources, and faculty feedback processes to improve QI faculty development are ongoing and sustained. Peer coaching provides continued support for faculty development. Initial process outcomes indicate that implemented strategies are well-received by faculty. The transition to competency-based education provides opportunities to create tools to measure multiple student quality and safety competencies highlighted in Domain 5 of The Essentials: Core Competencies for Professional Nursing Education and inform future directions for faculty development essential to support student success.

Curriculum and teaching methodologies that effectively refine DNP students' project proposals.

Despite early and continuing development of guidelines and frameworks by scholars and others, including AACN, to streamline the DNP project process, incorporation of DNP project resources into educational practice remains impeded. To share a curricular innovation and specific teaching methodologies aimed at refining DNP students' project proposals. Faculty developed a new DNP project proposal course utilizing low stakes writing assignments with feedback to elevate student learning and performance. Midterm evaluation allowed students to provide feedback and faculty to make course or assignments changes. End-of-course evaluation score showed the new course was above the overall college mean. The new course was associated with an increased number of successful DNP project defenses over previous methods. Implementing a structured DNP project proposal course is a successful and sustainable strategy and results in a streamlined approach and a more manageable pathway to complete DNP projects.

Establishing the doctor of nursing practice project ethical review process to improve standardization, efficiency, and timeliness

BackgroundDNP Scholarly projects require review for scientific merit and human subject protection. Rapid growth of DNP programs and projects has increased Institutional Review Board (IRB) burden and increased the length of project approval time when most DNP scholarly projects are quality improvement (QI) projects and not deemed Human Subjects Research (HSR). PurposeDevelop a process and describe the rationale for creating and implementing a Project Ethical Review Committee (PERC) in the School of Nursing and to evaluate the experience of the first cohort of submissions. ProcessCommittee was formed using expert consensus approach, in collaboration with IRB. Standards of Procedures and training materials created. Outcome measure100 projects submitted to committee; 95 deemed QI (95%) and 5 projects considered HSR (5%). First 94 projects were reviewed, and approval letters sent within 8 weeks. DiscussionThis paper discusses how PERC ensures rigorous and ethical review process for standardization, timeliness, and efficiency.

The mentoring role for DNP projects

The mentoring role for DNP projects

Development of a DNP measurement grid to increase the rigor of doctor of nursing practice students' data collection and analysis methods.

A key component of the DNP project rigor is the collection and analysis of data or measurement. A Steering Committee at the University of Maryland formed to improve the quality of DNP projects established a workgroup to evaluate the current measurement content in four DNP core courses with the goal of establishing DNP project measurement criteria across the curriculum. The steps included: Step 1: Identify QI Measurement Methods and Tools. Identify the essential QI measurement methods and tools recommended by national organizations. Step 2: Create a DNP Measurement Grid. Define main data methods topics with subtopics. Step 3: Map the DNP core courses. Using the DNP Measurement Grid criteria determine the measurement content included in each course and student mastery level. The level of mastery was ranked from introduced (awareness), to reinforced (knowledge), to demonstrated (application). Step 4: Evaluate and Refine the DNP Measurement Grid Criteria. Adjustments were made in the DNP curriculum to include topics and subtopics at the desired mastery level. The rigor of data measurement and analysis will be evaluated in future DNP projects. The workgroup's four-step process provides a path that facilitated improving curriculum measurement content. This process may provide guidance for others undertaking similar work.

An innovative course to prepare advanced practice registered nurses to spearhead quality and safety initiatives for older adults.

Current trends dictate that advanced practice registered nurses (APRNs) must be competent to address quality/safety issues specific to older adults. A gap analysis and review of key competencies in an adult-gerontology APRN-Doctorate of Nursing Practice (DNP) curriculum prompted the design and evaluation of an innovative online course, Quality and Safety for the Aging Adult. Course objectives align with key competencies, including graduate-level Quality and Safety Education for Nurses (QSEN) and the DNP Essentials. The course purpose was to prepare adult-gerontology APRN-DNP students as leaders to promote quality/safety outcomes for aging adults. The six-step Knowledge-to-Action Framework guided course development and evaluation. Select graduate-level QSEN competencies were used to construct a 20-item Quality and Safety Survey (4-point Likert scale) (Cronbach's alpha, 0.916). This survey was used during week 1 (pre) and week 15 (post) of the semester to evaluate students' preparation and confidence to perform key QSEN competencies. Significant improvements (p < .000) between pre/post scores on the Quality and Safety Survey were found across five classes. Students felt more prepared and confident to apply selected QSEN competencies on course completion. Moreover, nearly 60% (primary care) and nearly 35% (acute care) adult-gerontology APRN students selected the older adult population for their DNP projects. The Quality and Safety for the Aging Adult course positively influenced five classes of adult-gerontology APRN-DNP students. Integrating QSEN competencies with gerontology and quality/safety content is an effective strategy to prepare APRNs to lead quality/safety initiatives in aging adults. This innovative online course offers a successful model for innovative DNP education of adult-gerontology APRNs.

Using complex adaptive systems theory to guide the transition to DNP nurse anesthesia education.

The opportunities and challenges when transitioning from a master's to DNP in nurse anesthesia education are complemented by using a complex adaptive system (CAS) theory to guide the curricula modifications. Major functional changes included reorganizing the curriculum to incorporate AACN DNP Essentials, COA competencies and integrating the scholarly work of a DNP improvement project. These changes were infused while balancing the intensive clinical requirements of a nurse anesthesia curriculum. Highlights in the DNP curriculum included the driving theory of complex systems, ethical values, leadership development, evidence-based practice and adaptation to emergent situations found in nurse anesthesia practice. Goals were to produce a DNP graduate that is more reliant on strategy and vision rather than only tasks or operations. Using the CAS framework enabled our program to transition and prepare DNP graduates to contribute to improved organizational effectiveness and understand the importance of leading change to positively impact patient outcomes.

Seven Practical Tips for DNP Projects in Faith-Based Settings.

Seven Practical Tips for DNP Projects in Faith-Based Settings.

Mentoring students engaging in scholarly projects and dissertations in doctoral nursing programs

BackgroundDoctor of Nursing Practice (DNP) programs in the US have grown exponentially, outnumbering Doctor of Philosophy (PhD) in Nursing programs. Faculty are mentoring increasing numbers of students on DNP projects or PhD dissertations. PurposeThis descriptive study explored faculty characteristics and examined support, engagement, and outcomes of American Association of Colleges of Nursing member nursing faculty mentoring student DNP projects or PhD dissertations. MethodA researcher-developed survey tool was emailed to 550 Deans and Program Directors of AACN doctoral programs for distribution to their doctoral faculty. Survey data were analyzed using descriptive statistics. Findings177 DNP and 53 PhD (N=230) program surveys were completed. Faculty described challenges in the mentoring role including: time constraints, workload allocation, resources, faculty role preparation, student readiness, and variability in student outcomes. ConclusionsAdditional dialogue and consensus is required to promote mentoring of students in nursing doctoral programs to ensure rigor of scholarly outcomes.

Statistic Methods Used in Scholarly Projects of Doctor of Nursing Practice Graduates

Background: Most of the DNP programs provide only one Biostatistics course for the students, which means instructors have limited time to prepare DNP students in mastering the statistics skills they need to complete their scholarly project. Methods: Quantitative content analysis was conduct on 100 DNP projects to retrieve information regarding the subjects, sample size, sampling strategies, and statistics methods used. These projects were selected from two online DNP projects repositories, where DNP graduates uploaded their projects voluntarily. Results: Almost half of the projects had a sample size less than 50, majority of the studies adopted convenience sampling strategy, and the most often used statistics methods discovered were descriptive analysis, t Test, and Chi square analysis. Conclusion: Small sample size is an intrinsic problem of most DNP projects. The results of this study give DNP students and faculty a more clear teaching map that focuses on skills used most often.

An Academic-Practice Partnership Model to Grow and Sustain Advanced Practice Nursing.

The aims of this article were to describe the implementation of an academic-practice partnership for healthcare system workforce development and provide preliminary outcomes of the associated pilot study. The demand for cross-continuum healthcare delivery models necessitates creation of workforce development structures for advanced practice nursing. An academic-practice partnership specified enrollment of 5 cohorts of BSN staff nurses in a 3-year DNP program. Qualitative methods were used to explore pilot data at midpoint of cohort 1 student progression to determine learning outcomes and DNP projects with potential for impact on organization goals. Partnership implementation experiences indicate that contractual agreements and an established evaluation plan are keys to academic-practice partnership success. Pilot study findings suggest that curriculum core courses provide a foundation for designing DNP projects congruent with acute and primary care health system goals. Implementing an academic-practice partnership is a strategy for workforce development to increase retention of advanced practice nurses. Academic-practice partnerships can serve as a catalyst for a paradigm shift for changing models of care, thus enhancing workforce development succession planning for sustainable growth in healthcare systems.