Doctor Of Nursing Practice Programs Research Articles

Overcoming COVID-19 Challenges: Using Remote and Hybrid Simulation Designs in DNP Programs.

Simulation is a critical component of nursing and medical education used to teach skills and assess student performance. In March 2020, faculty members—including the authors—at the Grace Center for Innovation in Nursing Education at the Edson College of Nursing and Health Innovation (Edson College) simulation programs at Arizona State University quickly responded to the crisis presented by COVID-19. Within a few days, all nursing simulations were transitioned from a predominately in-person design to fully online. Maintaining simulation activities throughout the first several months of the pandemic allowed students at Edson College to meet clinical assessment objectives. This transition, implemented in 2 phases, included a detailed plan of action for all Doctor of Nursing Practice (DNP) nurse practitioner objective structured clinical exams (OSCEs). The challenges required innovative planning and flexibility while maintaining the integrity of the OSCE and simulation experience. The methods implemented out of necessity are now an important part of the authors’ curricular toolbox, providing options for continued and future educational practice. This paper details the simulations designed and implemented in 2 DNP programs: the family nurse practitioner and acute care pediatric nurse practitioner programs.

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.

Sustained impact of an academic-practice partnership

Academic-practice partnerships foster innovation and transition to nursing practice in healthcare systems. The purpose of this paper is to describe the impact of a public-private academic-practice partnership for Doctor of Nursing Practice (DNP) education designed to transform a large healthcare system's nursing workforce and model of care. The conceptual framework is organized around Rogers's (2003) principles of diffusion of innovation in organizations. A logic model illuminates how inputs, activities, outputs and outcomes resulted in sustained impact for graduates, the college and the healthcare organization. Partnership outcomes include education of baccalaureate and master's-prepared employed nurses (n = 95) in a DNP program for advanced practice nursing (APN) roles in the healthcare system; dissemination of scholarship; and revision of the healthcare system's research approval process. Sustained impact includes advancement of DNP-prepared graduates to complex leadership and practice roles; development of new programs and advanced practice roles based on scholarly project findings; expansion of population-specific patient programs; and extension of continuum- and access-to-care models in the healthcare organization. Recommendations include continuing development of academic-practice partnerships for transition to practice and advancement of roles and levels of champions to achieve sustained impact of academic-practice partnerships in healthcare organizations.

Practice environment, independence, and roles among DNP- and MSN-prepared primary care nurse practitioners

BackgroundMany nursing schools are adopting the Doctor of Nursing Practice (DNP) as the preferred model of nurse practitioner (NP) education and eliminating Master of Science in Nursing (MSN) programs. To date, no studies have explored the relationship between DNP preparation and NP practice environment, independence, and roles. PurposeThe purpos of this study is to compare practice environment, independence, and roles among DNP- and MSN-prepared primary care NPs. MethodsThis study used a cross-sectional design and observational regression analysis of survey data. FindingsDNP-prepared NPs reported: 1) more favorable NP-Physician Relationships, 2) fewer clinical hours, and 3) more practice leadership. These differences were, however, small and not significant at 0.05 level. DiscussionWe found no major differences in practice environment, independence, and roles among DNP- and MSN-prepared primary care NPs. As more nursing schools establish DNP programs and more DNP-prepared NPs enter the field, it is especially important to continue to study the impact of DNP preparation on the NP workforce.

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.

Exploring the necessity of establishing a doctor of nursing practice program from experts\u2019 views: a qualitative study

BackgroundComplex healthcare systems increasingly demand influential nurse leaders adept at managing changes in unstable environments. The doctor of nursing practice (DNP) prepares the nurses for the most advanced level of clinical practice. The aim of this study was to explore the necessity of establishing a DNP program in Iran from experts’ views.MethodsThe study used a qualitative descriptive approach. The participants consisted of 13 faculty members and Ph.D. candidates selected using purposive sampling. Data were collected through focus group and semi-structured interviews, and analyzed using qualitative content analysis.ResultsThe content analysis led to the extraction of two main categories: “providing infrastructures” and “DNP as an opportunity to make positive outcomes.“ConclusionsIt is concluded that it is not necessary to establish a DNP program for Iran’s nursing education system. Supplying infrastructures is a crucial component to establishing a new program in Iran. Although DNP, as an opportunity to drive positive changes, is recommended, in the current situation, using alternative solutions may yield better outcomes than establishing a DNP program.

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.

St. Luke's International University and University of North Carolina at Chapel Hill collaboration project to develop the first DNP program in Japan.

We report an international collaborative project to develop the first Doctor of Nursing Practice (DNP) program in Japan. We described the development and implementation of the first DNP program at the St. Luke's International University in Tokyo and the collaboration with the University of North Carolina at Chapel Hill in the United States. Faculty perceptions in both parties gradually evolved from the traditional perspective of international collaboration to the transitional and the beginning of the holistic partnership perspectives. The collaboration resulted in an innovative DNP program that directly addressed the gap between nursing education programs and Japan's clinical needs. The collaborative project cultivated a holistic international partnership. Rather than reporting a manual for international collaboration, we present our reflections and outcomes as narratives that others could use to achieve a holistic global partnership.

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.

Compassion fatigue, presenteeism, Adverse Childhood Experiences (ACES), and resiliency levels of Doctor of Nursing Practice (DNP) students

BackgroundDoctor of Nursing Practice (DNP) students often experience challenges that can cause poor academic performance and attrition. Known threats to nurses' professional quality of life and patient care include compassion fatigue and presenteeism; it is not known how these phenomena carry over from prior nursing experience to DNP students' academic experiences and subsequent NP practice. Adverse Childhood Experiences (ACEs) can also threaten nursing students' coping ability and overall wellbeing. Building resilience can combat the negative effects related to professional quality of life and traumatic experiences and promote nursing student success. ObjectivesMeasure compassion fatigue, presenteeism, ACEs, and resiliency in DNP students. Design: A cross-sectional survey was conducted with three cohorts of DNP students. SettingA DNP program at a large public American University. Participants: DNP students (n = 118) from four NP specialty tracks: Family, Pediatric, Psychiatric Mental Health, and Adult-Gerontology Acute Care. MethodsOnline surveys were sent to three cohorts of DNP students: one group before beginning the program and two groups, one year apart, before starting clinical rotations in the program. Surveys included measures for compassion fatigue, presenteeism, ACEs, and resiliency. ResultsThe demographics of this study sample was similar to other published DNP student samples. The students reported moderate levels of compassion fatigue, presenteeism, and resiliency. ACE scores ranged from 0 to 8 out of 10, and 50% reported at least one ACE. ConclusionsSurvey results from three DNP student cohorts indicate that many are pursuing advanced practice nursing education with a history of traumatic childhood events, demands of balancing work and school, and moderate resiliency levels. Many have symptoms of negative professional quality of life and presenteeism that could inhibit their job satisfaction and quality of care as an NP. Promoting DNP students' resiliency may improve their ability to thrive amidst academic and professional challenges.

Strategies for Strengthening Quality Improvement Projects in a Doctor of Nursing Practice Program.

Doctor of Nursing Practice (DNP) programs must assure that attention to safe quality healthcare is threaded throughout the curriculum and prepare students to lead quality improvement (QI) initiatives in healthcare systems. This article illustrates the integration of implementation science, QI methods, process and evaluation tools, and faculty enrichment as strategies to strengthen QI projects in a DNP program. A three-phased approach to implement strategies to strengthen QI projects in a DNP program and to enhance faculty engagement was undertaken. A needs assessment drove the development of strategies to strengthen QI in a DNP program. Outcomes of implementing strategies to strengthen QI in a DNP program showed rapid uptake of the concepts of QI process models into course content within the DNP curriculum. Strategies consisted of assessment of courses for gaps in QI content, faculty enrichment sessions on implementation science, QI processes and models, QI metrics and data analytics, embedding new content in the DNP program courses and the use of a rigorous evaluation tool for QI projects. When provided with QI mentors and tools, DNP students are prepared to lead QI initiatives in healthcare systems to improve the safety and quality of healthcare.

Enlightenment for Future Nursing Education from Evaluating Perception of Competencies of Doctor of Nursing Practice Programs

Lack of research still exists about how Doctor of Nursing Practice (DNP) prepared nurses meet the AACN Essentials of Doctoral Education for Advanced Nursing Practice. The goal of this study was to examine the perception of DNP prepared nurses and employers on how they met the AACN Essentials. Self-reported data was collected from a convenience sample of DNP prepared nurses and employers across the U.S. (n=202) through an electronic survey assessment. Overall, the participants perceived that the DNP prepared nurses were meeting the competencies with all Essentials receiving a mean score above 4 (agree). The lowest mean score (4.289) was rated for Essential Ⅶ (Clinical Prevention and Population Health for Improving the Nation’s Health). Two other low mean scores were 4.310 for Essential V (health care policy for advocacy in health care) and 4.360 for Essential IV (information systems/technology and patient-care technology for the improvement and transformation of health care). The perception that DNP prepared nurses rated for Essential III (4.49 ±.68, p =.026), VI (4.48 ±.84, p =.017), and the total Essentials (4.43 ±.67, p =.023), and other employers rated for Essential VI (4.02 ± 1.17, p =.042) were statistically significantly lower compared to those working as a DNP prepared nurse and an employer at the same time. The findings of this study have a number of important insights into the value of DNP prepared nurses for the future development of DNP programs in the U.S and the future initiation in other countries.

Doctor of nursing practice students' perceptions of professional change through the DNP program.

This thematic analysis study examined how post master's Doctor of Nursing Practice (DNP) students described personal and professional growth in their views of self, healthcare, and clinical practice that evolved as a result of the curriculum and experiences in the DNP program. The purpose of this thematic analysis was to describe and discuss perceptions of graduating post master's DNP students regarding personal and professional development that occurred during the DNP program to identify how DNP graduates saw themselves change and grow during the course of the DNP program. A thematic analysis method was used to code, categorize, and summarize data from 42 reflection papers of post master's DNP students into a thematic framework based on the eight DNP Essentials which are the framework upon which DNP programs build their curriculum and design student experiences. The authors systematically analyzed the statements from each student paper and drew interpretation of the students' statements into themes that were congruent with the eight DNP Essentials and one stand-alone category. Data analysis yielded 15 themes that were aligned within eight categories of the DNP Essentials and one stand-alone category. The eight DNP Essentials provided a framework for the themes which reflected professional growth attributed to the journey through the DNP program. A ninth category entitled Personal Advancements described students' perceptions of their personal and professional development. These dimensions are proposed in the new DNP Essentials currently in development. Increasing understanding of the DNP students' journey serves to inform DNP curriculum development and program experiences, and informs faculty of the influence they have on molding students into a more robust professional role.

Academic-Practice Partnerships: Building a sustainable model for Doctor of Nursing Practice (DNP) projects.

DNP programs should follow the Academic-Practice Partnership guiding principles developed by the AACN-AONE Task Force of Academic Practice Partnerships (2012) to support students educational and practice experiences. This paper outlines the collaboration between a college of nursing (CON) and academic medical center in establishing a formal process for identification and vetting of student DNP projects. A collaborative committee called DNP Project Oversight Committee (DNPPOC) was formed. DNPPOC members outlined a number of processes to facilitate DNP project review, key stakeholder input, and developed several tools to accomplish the committee's goals. A survey was sent to DNPPOC members to solicit their feedback on meeting the committees overall goals. Medical center leadership reported improvements in the collection of key DNP project information and the distribution of DNP projects across facilitators and geographic locations. There was also report of perceived improvement in the overall quality of student learning opportunities, strategic direction of DNP projects, and alignment between CON and healthcare system goals. Processes developed by the DNPPOC have allowed the organization to handle the increase in DNP projects and maximize organizational resources. The DNPPOC structure has ensured high-quality DNP projects and that DNP students are prepared to be leaders in quality improvement.

Doctor of Nursing Practice Team Project Synthesis Form.

The importance of teamwork in health care, the need for doctorally prepared advanced practice nurses, and the nationwide faculty shortage provided the impetus for an educational tool to synthesize the doctor of nursing practice (DNP) project. Clearly outlining the stages of the DNP project in a concise manner, the DNP project synthesis form aids learners and faculty in organization and documentation of planning, implementation, and evaluation of the project and serves as a one-stop resource when students are completing semesters. This article delineates why one school of nursing developed a project synthesis form for use across all DNP programs.

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

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

An innovative teaching model in an academic-practice partnership for a Doctor of Nursing Practice program.

Teaching innovations in Doctor of Nursing Practice (DNP) programs are essential for preparing practitioners for role responsibilities. The purpose of this paper is to describe a teaching model implemented in a public-private academic-practice partnership in which DNP-prepared healthcare organization nursing leaders joined with college of nursing faculty to teach didactic courses in the DNP program. The conceptual framework for this model is organized around Boyer's (1990) principles of the scholarship of teaching, integration, and application, and the American Association of Colleges of Nursing definition of scholarship (2018). A logic model evaluation plan of the teaching model includes a description of inputs, activities, outputs, and outcomes. Outcomes include the attainment of short term goals related to student satisfaction and DNP program completion; faculty and peer satisfaction; and administrator perspectives. Future evaluation will include assessment of long-term impact of the teaching model. The teaching model can be replicated in preparing cohorts of students for advanced practice nursing and cultivating the scholarship of teaching, integration and application.

Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track

BackgroundIn 2004, the American Association of Colleges of Nursing (AACN) called for all nursing schools to phase out master's-level preparation for advanced practice registered nurses (APRNs) and transition to doctor of nursing practice (DNP) preparation only by 2015. Today, five years after the AACN's deadline, nursing has not yet adopted a universal DNP standard for APRN practice entry. PurposeThe purpose of this paper is to examine the factors influencing the ability of nursing schools to implement a universal DNP standard for APRNs. MethodsDeans from top-ranked nursing schools explore the current state of the DNP degree in the US. The authors draw upon their collective experience as national leaders in academic nursing, long-time influencers on this debate, and heads of DNP programs themselves. This insight is combined with a synthesis of the literature and analysis of previously unpublished data from the AACN on trends in nursing doctoral education. FindingsThis paper highlights issues such as the long history of inconsistency (in messaging, curricula, etc.) surrounding the DNP, certification and accreditation challenges, cost barriers, and more. The authors apply COVID-19 as a case study to help place DNP graduates within a real-world context for health system stakeholders whose buy-in is essential for the success of this professional transition. DiscussionThis paper describes the DNP's standing in today's professional environment and advances the conversation on key barriers to its adoption. Insights are shared regarding critical next steps to ensure national acceptance of the DNP as nursing's terminal practice degree.

Optimizing impact through the Tiered Doctor of Nursing Practice Project Model.

Colleges of Nursing (CONs) and health care organizations (HCOs) are increasingly embracing academic-practice partnerships (AcaPP). An HCO's workforce development plan prompted an AcaPP agreement with a CON for the purpose of increasing the number of doctor of nursing practice (DNP) advanced practice nurses in the HCO. Over a period of 6 years, 4 consecutive cohorts of approximately 100 HCO baccalaureate prepared nurses were enrolled in the CON DNP program. The AcaPP environment facilitates large-scale DNP projects among successive cohorts of students. The purpose of this article is to describe the innovative Tiered DNP Project Model, defined as the process by which current students build on and expand select DNP projects implemented by students in initial cohorts. The tiered approach to the DNP project is facilitated by an advising model that occurs in the context of mutually agreed-upon goals and compatible with the HCO strategic plan and CON DNP program objectives. In the Tiered DNP Project Model, select studies are chosen for continuation by DNP students in subsequent cohorts based on nursing leadership guidance of alignment with HCO strategic goals. The model has resulted in driving improvements in HCO patient and systems outcomes, promoted practice scholarship, and contributed to the quality of the CON DNP program.

Facilitating faculty knowledge of DNP quality improvement projects: Key elements to promote strong practice partnerships.

Enrollment in Doctor of Nursing Practice (DNP) programs is growing rapidly. This poses a challenge to faculty because there is a gap in knowledge about evidence-based practice and quality improvement DNP projects. Challenged by the growing unavailability of preceptors and mentors in the practice setting, solutions are needed to help students meet the essentials of the degree and competencies for practice. Faculty knowledge of key DNP quality improvement project elements, measuring, monitoring, and sustaining improvement outcomes, may help students design projects to provide value to practice partners. A literature review was conducted to identify gaps in faculty knowledge of potential practice partners' value-added elements of DNP quality improvement projects (measuring, monitoring, and sustainability) to make recommendations for faculty development to improve DNP project mentoring. There is evidence in the literature that faculty feel ill-prepared to mentor DNP projects. Quality improvement content is available for faculty development in the nursing and other health sciences literature. Optimizing faculty knowledge regarding evidence-based practice, quality improvement processes, and mentoring of sustainable DNP projects that improve health care provides value to practice partners and may advance long-term partnerships. Adding structures to support faculty knowledge in these areas contributes to solutions to the challenges of rapidly expanding DNP programs.