Doctor Of Nursing Practice Education Research Articles

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 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.

Celebrating over 20 years: Outcomes from the first doctor of nursing practice program.

The first Doctor of Nursing Practice (DNP) program was opened at the University of Kentucky College of Nursing (UKCON) in 2001. As the CON celebrates 20 plus years of DNP education, leaders decided to do an assessment of the accomplishments and outcomes from the work of graduates. The purpose of this study was to delineate the achievements, outcomes and perception of the impact of graduates from the UKCON DNP program and assess the correlations of specific "perception of impact" variables. DNP graduates from 2005 to 2021 (n=348) received an email about the study and a link to the survey. Ninety graduates who resided in 14 states responded. Over 84% of participants indicated that their DNP degree helped them stand out as a leader. Participants reported that having a DNP education increased their knowledge and expertise in multiple areas, including how to lead, to influence, and to improve outcomes within their organizations. Narrative feedback related to top achievements since graduation included career advancement/promotion (n=22), improving patient care quality/implementation of evidence-based initiatives (n=21), and becoming a better leader (n=19). This study illustrated the broad return on investment and the quantification of value that a DNP education brings, both to practice and academia.

Barriers, facilitators, and opportunities for Doctor of Nursing Practice engagement in translational research

BackgroundLittle is known about how Doctor of Nursing Practice (DNP) graduates apply translational research competencies in the practice setting. PurposeThis qualitative descriptive study aimed to explore the barriers, facilitators, and opportunities for engaging in translational research among DNPs in practice. MethodsWe conducted semi-structured interviews with 11 DNPs working within an 8-hospital health system from November 2020 through July 2021. DiscussionWe identified four themes related to barriers (invisibility of the DNP degree and skillset; lack of role clarity and organizational structure for DNPs; lack of time for engagement in translational research; lack of support for engagement in translational research), one theme related to facilitators (encouragement from colleagues and supervisors), and two themes related to opportunities (DNP education promotes recognition of nurse role in translational research; DNPs are interested in role expansion to include translational research). ConclusionDNPs have the interest and training to engage in translational research but face structural barriers to doing so.

The business of Doctor of Nursing Practice (DNP) education: Practical application strategies to apply business concepts in DNP education.

The purpose of this article is to 1) review updated business competencies in The Essentials: Core Competencies for Professional Nursing Education for Advanced-Level Nursing Education (2021) and 2) suggest strategies on how to integrate business and finance concepts encompassing quality, safety, and systems-based practice into DNP educational curricula. The Institute of Medicine recognizes strong nursing leadership on all system levels from "bedside to boardroom" as critical to redesigning healthcare that is affordable and accessible. The business of healthcare requires the DNP-prepared nurse to be equipped to understand and navigate business principles necessary for sustainable change to improve patient outcomes. The updated 2021 AACN Essentials include enhanced business concepts and competencies as curricular elements to prepare practice-ready DNP prepared leaders. Current healthcare translation of research to practice has historically been slow, and only recently has the average time for research to translate to practice decreased from 17years to 15years. DNP-prepared nurses, as evidence-based practice and quality improvement experts, are positioned perfectly to reduce this research translation time gap to improve patient outcomes by implementing evidence-based change. Employers outside the academic setting, and arguably even within the academic setting, often fail to understand this unique skill set of a DNP-prepared nurse. A lack of business expertise disadvantages s the DNP-prepared nurses 'ability to effectively communicate and demonstrate the ROI and value added to an organization or interprofessional team. Achieving competency with business concepts during DNP education such as marketing, budgeting, return on investment, healthcare finance and interprofessional collaboration are critical components for a practice-ready DNP graduate as noted within the revised AACN Essentials (2021). The didactic content of business education that meets the 2021 AACN Essentials can be integrated in established DNP core courses or through creating new courses in the curriculum. Students through innovative assignments, immersion experiences, and the DNP final scholarly project can demonstrate application and competence of learned business principles. Strategically integrating business concepts into DNP curriculum provides multiple benefits to the DNP graduate, organizations, and ultimately, patients.

DNP preparation of primary care nurse practitioners and clinical outcomes for patients with chronic conditions

BackgroundMany professional nursing organizations have proposed that the Doctor of Nursing Practice (DNP) is the most appropriate entry-level degree for nurse practitioners (NPs). There have been no studies to date examining the impact of DNP preparation on quality of care or patient outcomes. PurposeTo examine differences in emergency department utilization and hospitalizations among patients with chronic conditions cared for by Master of Science in Nursing (MSN)- and DNP-prepared primary care NPs. MethodsWe use survey data from over 1,000 primary care NPs in 6 states linked to Medicare claims data. Using regression models, we controlled for various patient, NP, and practice characteristics that might confound the relationship. ResulsWe find that patient outcomes are not statistically different between patients attributed to MSN- and DNP-prepared primary care NPs. DiscussionThese findings suggest that there remains little evidence that DNP education has led to significant improvements in patient outcomes. ConclusionsFurther empirical analysis related to the clinical outcomes other than health care utilization of the DNP degree is warranted. Future studies might consider examining (a) NPs in settings other than primary care, (b) practice-wide or system-wide outcomes, (c) other measures of care quality, and (d) impact of DNP program content.

Recommendations for evolving a doctor of nursing practice program.

As Doctor of Nursing Practice (DNP) programs have evolved within the nursing profession and nursing academia over the last 20years, pedagogy and curriculum in DNP education have also continued to evolve. Educational innovation requires continuous assessment to ensure quality and efficacy are maintained. Using the Knowledge to Action (KTA) framework, we adapted the knowledge regarding best practices in a DNP program to fit our College of Nursing needs, our community of learners, and sustain this process improvement by implementing programmatic changes that enhanced the quality and rigor of the DNP program. A newly formed task force identified barriers and opportunities including lack of DNP-prepared faculty, changes needed to the scholarly project paper, revision of the DNP curricula, and a need for a mentor group model to replace the traditional committee structure. Recommendations to strengthen DNP programs include choosing a process model or framework to serve as a guideline for program evaluation and improvement, create a faculty-led task force that continuously monitors program elements, and conduct annual mini retreats to facilitate faculty discussion and review of program elements.

State of DNP education: Lessons learned from a novel academic fellowship in teaching and education.

We examine the gap between the current and desired state of Doctor of Nursing Practice (DNP) education from the perspective of postdoctoral (DNP) teaching and education fellows. In the assessment of the DNP Essentials framework, command of scholarly and scientific writing, ability to demonstrate critical thought, and significant variation in clinical experience among DNP graduates are top concerns. These inconsistencies are problematic to the professional and public value of this terminal degree in nursing.

Intentions to advance professional identity attributes among DNP students: The make it POP series leadership pilot program study.

Make It POP (Pathway Optimizing Professionalism) Series (MIPS) leadership educational sessions were developed and taught by the Dean as a curricular focus on professionalism for Doctor of Nursing Practice (DNP) students. Evaluating the association between Behavioral Beliefs, Normative Beliefs, Control Beliefs, and Intention to advance professional identity and values was a focus of this study. A secondary focus was to discern whether these Belief measures and attendance to the MIPS education series were predictive of Intention to increase professional identity and values. Over a two-year period, 227 students were invited to attend the MIPS courses, which included four once per semester sessions. Students were invited to complete a survey structured around the tenants of the Theory of Planned Behavior prior to attending the MIPS and following each session; 91 students completed the survey at least once. A significant relationship was not noted between attendance to one or more MIPS sessions and Intention to advance professional identity and values. Behavioral Beliefs and Control Beliefs had the strongest associations with Intentions, but normative beliefs were not significantly associated with Intentions. Integrating curricular innovation with meaningful engagement and reflection in DNP education may advance DNP student's commitment for sustained professional growth.

Enhancing DNP Project Success: A Statistical Collaboration Approach.

The Doctor of Nursing Practice (DNP) project is the culmination of DNP education, serving as evidence of knowledge preparation and skill achievement in translating evidence into practice. Review of sample DNP projects from 2015 to 2019 revealed that multiple projects had fatal flaws in the Methods and Evaluation sections, rendering the resulting DNP project with diminished value. We established a collaborative relationship with an educational statistics program and associated consulting center to develop and integrate statistical resources directly into the planning and evaluating stages of the DNP project process. The pilot program included workshops and individual consulting sessions provided to the student aimed at reducing fatal flaws and improving research design and evaluation analyses. Initial and follow-up surveys were adapted from the Course Experience Questionnaire to assess student satisfaction and perceived knowledge gains. Project rigor and value were assessed using the DNP-Project Critical Appraisal Tool (PCAT). The pilot program showed a decrease in the number of fatal flaws and an increase in PCAT scores on the targeted Design and Evaluation sections.

The Influence of the Doctor of Nursing Practice on West Texas Health Care: Case Study

This case study reflects the journey taken by multiple individuals as they considered the doctor of nursing practice (DNP) evolution within one suburban acute care setting. The DNP education that the chief nursing officer (CNO) experienced led to a major change for all the nursing leaders in the organization. Two CNOs provide their unique path and insights to building a leadership team composed primarily of DNP-prepared leaders, sustaining the momentum, and fostering further growth in an isolated area of West Texas. Findings from a qualitative study on the perceived impact of the DNP education and actionable steps are shared.

Bibliometric analysis of the Doctor of Nursing Practice dissertations in the ProQuest Dissertations and Theses database.

To examine the distributed characteristics and explore the research themes of Doctor of Nursing Practice (DNP) dissertations during the past two decades. A descriptive statistical and visualization bibliometric analysis was conducted. Doctor of Nursing Practice dissertations submitted between January 2005 and June 2021 were collected from the ProQuest Dissertations and Theses database. A descriptive statistical analysis was conducted to calculate the distribution of the DNP dissertations by granting institution and the published year of publications. The VOSviewer 1.6.13 was used to explore the bibliometric networks and research priorities of the DNP dissertations. A total of 4989 DNP dissertations from 90 universities were included in this study, all from the United States. The number of DNP dissertations showed an upward trend, with steady growth from 2005 to 2014 and rapid growth after 2015. The DNP studies focused on five areas: health care management in clinical nursing, advanced practice in nursing education and health education, public health problems, mental health care for adolescents and nurses and the older people care and long-term care. Parallel to the numerical increase in DNP dissertations is a steady expansion in the range of research topics and scopes, which is aligned with specific specializations of the DNP. Many are interdisciplinary and employ techniques imported from the fields of public health, psychology and social sciences, resulting in nursing educators and practitioners continually broaden their subject perspectives. Knowing where, when and why DNP research trends developed will help nursing educators to further develop DNP education and optimize DNP programs in the future, such as paying more attention to the nursing practice. Moreover, this study will inspire DNP students and researchers to expand their subject perspectives and broaden the research scope to solve nursing practice problems based on interdisciplinary theories and methods.

Nursing Knowledge in the Doctor of Nursing Practice Curriculum.

The goal of Doctor of Nursing Practice (DNP) education is to prepare advanced practice nurse leaders for the practice setting. Accordingly, it is imperative that DNP education is grounded in nursing theoretical knowledge. The purpose of this project was to examine the presence of nursing theoretical knowledge within DNP programs across the United States. A retrospective approach was used to review publicly available information on the webpages of a sample of DNP programs accredited by the Commission on Collegiate Nursing Education (CCNE) to determine if nursing theoretical knowledge guided DNP programs. Demographic information was also collected. A sample of 100 CCNE accredited programs revealed a lack of nursing theoretical knowledge visible within DNP programs. It is unclear how DNPs are being prepared to be practice leaders guided by nursing theoretical knowledge. Nursing leaders must develop policies to assure that nursing knowledge is core in DNP programs.

The Need for Advanced Clinical Education for Nurse Practitioners Continues Despite Expansion of Doctor of Nursing Practice Programs.

We read with great interest Mundinger and Carter's exposition of how, in their view, Doctor of Nursing Practice (DNP) education has lost its way and what consequences might result. Mundinger and Carter note that DNP programs are overwhelming focused on nonclinical practice. We share the concern of Mundinger and Carter about the future of nurse practitioner (NP) education within the context of expanding DNP programs. In this commentary, we raise concerns about NP transition to practice and the limited, but concerning, evidence that new NPs struggle in their transition to practice. We note that this concern is magnified as NPs continue to move into specialty roles. Health systems have responded to this concern by developing residency and fellowship programs. Fifteen years after the AACN position statement on the clinical doctorate was issued, the goal of DNP education remains an unfinished project. An important question remains: Can, will, and how should DNP programs deliver?

Transformative Learning in an Online Doctor of Nursing Practice Population Health Course.

Population health is a critical component of Doctor of Nursing Practice (DNP) education, providing the foundation for clinical prevention, health equity, responsible policy, and practice change. Many DNP learners enter population health courses focused on individual patient care in microsystems. Transformative learning broadens learners' perspectives about health determinants and implications for health system transformation. Transformative learning strategies were imbedded in a 10-week, online population health course. Students engaged with readings and multimedia content and wrote anonymous reflective analyses about population health determinants. Qualitative survey data were explored for transformative content using line-by-line content analysis. The stages of transformative learning were used as a priori codes. Learners questioned their own beliefs and epistemologies and demonstrated all aspects of transformative learning, although not equally across course topics. To achieve the promised outcomes of DNP education, population health content should be professionally transformative and integrated across the curriculum. [J Nurs Educ. 2019;58(8):481-484.].

The DNP Degree: Are We Producing the Graduates We Intended?

This study addressed how recently graduated doctor of nursing practice (DNP) nurses describe their current practice, how their supervisors describe the DNP's current practice, and whether nurse and supervisor descriptions of the practices reflect the American Association of Colleges of Nursing (AACN) DNP Essentials and, if so, how? Introduced in 2004, the goal of DNP programs was to educate advanced practice RNs for effective leadership in complex healthcare environments. The value of the DNP degree for nurses in healthcare systems is evolving. We used conventional content analysis to inductively describe how DNP graduates from 7 different schools and their supervisors described the practice of the recently graduated DNPs. Interviews were reviewed to assess whether the AACN DNP Essentials were enacted in practice. The overarching theme was "becoming more: re-envisioning self as an agent of change." Results support the claim that DNP education prepares advanced practice nurses for leadership across complex healthcare systems. Evidence of the DNP Essentials is realized when graduates perceive themselves as equal to other leaders and capable of driving change using evidence and effective collaboration.

Evaluating Leadership Competency in DNP Clinical Practice

Evaluating the growth of leadership competencies of Doctor of Nursing Practice (DNP) students in academic and organizational settings has been a challenge. The purpose of developing a method of evaluating DNP student leadership focused on a strategy to assess DNP student growth in the areas associated with leadership and change. Competencies of leadership that were evidenced based and effective in healthcare environments were employed as a basis for the leadership narrative. The resulting tool served both as structure for the student's development and as a method of instruction and evaluation in the academic setting. Using a descriptive and experiential leadership narrative as one method of evaluation is an effective strategy for fostering DNP student leadership development in both the direct patient and system-focused settings. Moreover, the leadership narrative is easily generalizable and transferable in environments where growth in leadership and competency development is valued. The process of developing leadership narratives is a transformational experience for the doctoral student and future nursing leader. Easily incorporated into the DNP practicum structure and beyond, the leadership narrative is an effective method for formative and summative evaluation of DNP student leadership development. Moreover, consistent with the accrediting body for DNP education, the leadership narrative can be used as one method of demonstrating program effectiveness.

DNPs’ labor participation, activities, and reports of degree contributions

There is limited information about the careers, roles and views of doctor of nursing practice (DNP) graduates. This study describes the labor participation, post-graduation work activities, and perceptions of 1,308 DNP members of three professional nursing organizations who completed a 2017 survey (32% response rate). More than 70% of respondents reported substantial improvements in quality improvement, evidenced based practice and leadership abilities. Twenty-two percent of respondents noted the degree was required by their employer and most of these held educational positions. Postgraduate participation in activities associated with DNP education, assessment of personal impact and degree necessity varied by position title and organization membership. These differences have implications for nursing associations and professional solidarity.

Identifying Motivational Factors for Enrolling in a Doctor of Nursing Practice Program.

Students enter Doctor of Nursing Practice (DNP) programs for varying reasons. An understanding of motivational factors is needed so nurse educators can address upon program entry student engagement strategies to promote retention and success in completing a DNP program. This article presents the findings of a descriptive study that explored newly admitted students' motivational factors for pursing DNP education. A 20-item online survey was distributed to newly admitted DNP students at a university in western Pennsylvania. The survey consisted of eight demographic questions and 12 statements that reflected six intrinsic and six extrinsic motivational factors. Intrinsic motivational factors were reported as slightly more influential than extrinsic motivational factors. Relationships were found between length of employment, length of experience, length of time considering to enroll, and motivational factors. Cultivating intrinsic motivation upon program entry may positively influence engagement, retention, and successful program completion of DNP students'. [J Nurs Educ. 2018;57(11):680-683.].

Appreciative Advising Pilot Study: An Innovative Approach to Advising Doctor of Nursing Practice Students.

Traditional advising may not meet the needs of doctor of nursing practice (DNP) students. Founded on the principles of appreciative inquiry, appreciative advising serves as a promising alternative model. The purpose of this pilot study was to determine feasibility of a DNP appreciative advising model to advise students through the rigors of DNP education and improve student and faculty satisfaction. Faculty were oriented to the model and provided comprehensive guidebooks. Survey data were collected at 4 time points. Quantitative survey data were analyzed using descriptive statistics. Qualitative responses were analyzed using qualitative content analysis. Twenty-six students and 7 faculty who participated reported satisfaction with the model and commented that the model allowed for early identification of needs and was helpful and worthwhile. The model may hold promise as a solution to assist students in adjusting to DNP education and deserves further exploration as an advising approach.

Quality and Safety Education for Nurses Competencies in Doctor of Nursing Practice Education: Exemplars From Education and Practice.

Graduate level Quality and Safety Education for Nurses (QSEN) competencies were created to facilitate preparation of the Doctor of Nursing Practice (DNP) graduate to have an impact on health care system changes, advance nursing practice, and improve the health of populations. Although there is agreement that QSEN competencies are important to DNP education, little is known about implementation of the competencies. This article describes the importance of QSEN competencies in DNP education and provides exemplars of QSEN competencies in DNP education and practice.