Doctor Of Nursing Practice Project Research Articles

The DNP project: Two decades of impact.

Twenty years ago, pioneer Doctor of Nursing Practice (DNP) program students completed the first DNP projects. Today, DNP projects remain a requirement for graduation. This article illustrates how the DNP project can be integrated throughout the DNP curriculum to maximize effectiveness and promote the introduction, reinforcement, and evaluation of competencies in the new American Association of Colleges of Nursing Essentials.

Reducing falls among residents of retirement homes: A DNP project.

Falls among older adults (OAs) living in retirement homes (RHs) in Canada are a major public health concern due to high morbidity and mortality as well as significant healthcare expenditures. This quality improvement (QI) initiative, conducted for the author's Doctor of Nursing Practice (DNP) project, aimed to decrease fall rates and ED transfers related to falls among OAs in six RHs across the Greater Toronto Area in Ontario, Canada through a multipart intervention with two primary goals. First, the project aimed to facilitate RH NPs' implementation of a comprehensive fall risk assessment and fall prevention strategy in their practice by incorporating the Stopping Elderly Accidents, Deaths & Injuries (STEADI) toolkit into their armamentarium. Second, it sought to enhance the knowledge of the RHs' registered practical nurses (RPNs), personal support workers (PSWs), and unregulated care providers (UCPs) in assessing fall risk and incorporating fall prevention strategies in their daily practice. By improving NP, RPN, PSW, and UCP knowledge and increasing (by 20%) RPN, PSW, and UCP use of fall prevention strategies, this QI initiative successfully reduced fall rates in the RHs by 40.4%, with no falls requiring transfer to the ED, in the postintervention period. The results of this project highlight the need for an interdisciplinary approach to fall risk reduction in RHs that includes implementation of multifactorial intervention strategies as well as effective organizational policies and procedures for maximum impact.

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.

Expert-Type Content Validity Applications to Doctor of Nursing Practice Projects.

Background: Developing rigorous doctor of nursing practice (DNP) projects continues to challenge faculty and doctoral students. To address project rigor, expert content validity methods have been applied to clinical projects. Students implement expert content validity processes to literature-based project components. Objectives: The objectives of this study are to describe some of the developmental phases of DNP projects during the courses of one DNP program and to explore one strategy for increasing the rigor of DNP projects, review details on expert-type content validity methods, and examine literature for projects implementing an alternate application of expert-type content validity and scoring approaches to components of DNP projects. Methods: Expert content validity methods are described for DNP projects, such as guidelines, teaching plans, support groups, and algorithms. They are used to judge components generated from initial content analysis strategies. Types of expert panelists and descriptions of scoring ranks on project components are presented to represent different expert content validity strategies. Results The steps are presented to support expert content validity processes. Conclusions: DNP projects challenge faculty and students to create systematically constructed quality improvement projects on important and interesting clinical problems. The expert context validity process is one approach of enhancing project rigor. Implications for Nursing: An outline offers steps to establish expert content validity for translational DNP projects.

Exploring Clinical Practice Hours in Postbaccalaureate-to-Doctor of Nursing Practice Nurse Practitioner Programs.

Advanced practice nursing education is evolving to the doctor of nursing practice (DNP) degree. The American Association of Colleges of Nursing (AACN) DNP Essentials required 1000 hours of direct patient care, whereas the Report of the National Task Force on Quality Nurse Practitioner Education (NTF) Criteria for Evaluation of Nurse Practitioner Programs required 500 direct patient care hours. Indirect hours were unclear and undefined. The AACN Essentials changed the 1000-hour requirement to 500 practice hours, and the NTF increased the direct patient care hours to 750. The study sought to describe the distribution of direct and indirect hours that the National Organization of Nurse Practitioner Faculties member schools offer in their seamless postbaccalaureate-to-DNP nurse practitioner (NP) program. A quantitative survey was distributed to schools of nursing. Eighty-six surveys represented 86 distinct schools and 112 NP programs. Supervised direct patient care hours were an average of 791.31 hours. Indirect hours averaged 170.08 hours. The DNP project hours served as an indirect hour activity. Many schools have more than 750 direct hours adhering to the 2022 NTF Standards. The indirect hour allocation varies and weighs heavily on the DNP project.

From Digital Commons to Alma/Primo: enhancing the dissemination of Doctor of Nursing Practice (DNP) projects.

The Doctor of Nursing Practice (DNP) project collection is a group of approximately 120 DNP projects archived between 2017 and 2022 in Health Sciences Research Commons (HSRC), the health sciences institutional repository (IR) for the George Washington University. Our project focused on expanding avenues for the dissemination of DNP projects beyond our Digital Commons IR by integrating this content into the library's instances of Ex Libris Alma and Primo VE. By utilizing the Ex Libris Repository type import profile rather than the OAI-PMH feed, we identified enhanced opportunities for content discovery while likewise retaining better control over individual item records.

Doctor of Nursing Practice and Its Application to School Nursing.

School nurses who are considering a terminal degree in nursing have two options, a Doctor of Nursing Practice (DNP) or a Doctor of Philosophy in Nursing (PhD). There are several factors for school nurses to consider when determining which terminal degree is best suited for them. This article focuses on the relevance of a DNP degree to school nursing, by first reviewing the evolution of DNP programs and then pivoting to discussions by three school nurses on why they chose this terminal degree and the projects completed during their courses of study. A main focus of a DNP project is to gather, analyze, synthesize, and translate research into practice, often operationalized as quality improvement (QI) in clinical settings. School nurses, practicing independently from other healthcare professionals while often managing large workloads, stand to benefit from obtaining or working with a nurse prepared at this level.

Academic Practice Partnerships: Improving Doctor of Nursing Practice Project Quality.

Doctor of nursing practice (DNP) projects with impactful health system outcomes can be a challenge for graduate students and graduate program faculty to develop. Rigorous DNP projects address patient and health system needs, meet programmatic requirements, and result in a portfolio of sustainable scholarship for DNP graduates. A strong academic-practice partnership may result in a greater likelihood of successful and impactful DNP projects. Our academic-practice partnership leaders developed a strategic approach to align health system priorities with DNP student project needs. This partnership has resulted in project innovation, increased clinical application, improved outcomes within the community, and enhanced project quality.

Integrating Writing Throughout the Curriculum in Doctor of Nursing Practice Programs: A Collaborative Model for Success

Historically, faculty in Doctor of Nursing Practice (DNP) programs have noted poor student writing proficiency, which is associated with substandard oral and written communication skills, analytical reflection, and professional role attainment. Few studies have investigated incorporating integrative collaborative model Writing Across the Curriculum (WAC) strategies in DNP programs. This study evaluated the efficacy of this model on the writing proficiency of students in their final year of the DNP program. This mixed-methods study examined how a collaborative model using WAC strategies affects DNP project value and rigor, writing proficiency, and student satisfaction. Student writing proficiency improved significantly, resulting in statistical improvement in DNP project value and rigor. Students viewed the collaborative model favorably when using the incorporated WAC strategies. A collaborative WAC model used by nursing faculty, writing resource centers, and a research librarian effectively improved the writing skills of DNP students. [J Nurs Educ. 2023;62(4):241-248.].

Innovative DNP Evaluation Tools

Background: Innovative strategies are crucial for addressing essential faculty knowledge for teaching and advising Doctor of Nursing Practice (DNP) students, especially during the phase of time-sensitive scholarly projects. Challenges of diverse educational and experiential background of faculty may contribute to inconsistent student advisement and learning. Lack of clear expectations creates barriers to student learning. Methods: Published reports and faculty input were used to develop evaluation tools utilized in DNP project courses. The tools allowed for clear expectations of faculty instruction and advising, student work, and fostered student growth. Results: Rubrics developed for DNP project courses facilitated diverse student learning needs. Evaluation tools, informed by national guidelines, were developed to guide DNP faculty and student success, resulting in consistent evaluation of student scholarly work and attainment of the DNP Essentials Conclusions: Student evaluation tools that reflected the national guidelines facilitated student learning and assisted faculty instruction and advising. These rubrics have positioned our college for the transition to competency-based doctoral education. Implications for Nursing: The tools shared in this article could be adapted to fit other DNP programs aligning critical elements of students' attainment of knowledge, skills, and abilities of the DNP degree in the move toward competency-based education in the newly revised Essentials (2021).

The Doctor of Nursing Practice help desk: An innovative approach to developing evidence-based practice competency and providing DNP project support.

The 2021 American Association for Colleges of Nursing (AACN) Essentials for Professional Nursing Education identifies evidence-based practice (EBP) as a core concept meant to be integrated across curricula. Integrating EBP in Doctor of Nursing Practice (DNP) programs is challenging because of barriers including persistent confusion between research, EBP, and quality improvement; low faculty confidence and competence in their EBP skills and mentoring; increased faculty workload with growing program enrollments; and limited opportunities for students and faculty to practice EBP skills. The aim of this initiative was to implement and evaluate an innovative education strategy to build DNP students' and faculty's EBP competency and confidence while mitigating barriers faced by DNP programs. A DNP Help Desk was created and implemented at a large, Midwestern college of nursing with participation and support from EBP experts. Student and faculty participation were tracked, and perceptions of the help desk were evaluated. Opportunities to evolve the help desk were identified and implemented. Outcomes included a self-reported increase in student and faculty confidence and EBP competency, increased integration, and utilization of EBP in project work, elevated DNP project quality, and decreased demands on DNP project advisors. Engaging in innovative strategies aimed at increasing EBP competency and confidence may lead to increased EBP engagement and positive outcomes for students, faculty, and DNP programs.

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.

Doctor of nursing practice project: Key challenges and possible solutions.

To thoughtfully and strategically embed the updated Essentials into Doctor of Nursing Practice (DNP) curricula, it is important to understand the current landscape of the DNP project. This discussion focuses on DNP project processes, providing a summary of the core challenges and solutions for project design, implementation and evaluation stages. Main challenges include: Difficulty defining a practice gap or absent training in protocol development for quality improvement (QI) projects (design stage); difficulty identifying and accessing project sites or practice mentors and limited academic faculty support (implementation stage); and a lack of common criteria for DNP project evaluation or unclear choices and use of QI measurement tools (evaluation stage). Scholarly Writing, Faculty Preparation, and Sustainability were overarching challenges hindering successful completion of DNP projects. Possible solutions included training and support for faculty, toolkits and practical strategies to support planning and organization. The DNP, as an evolving degree, brings its own set of challenges for students, academic and clinical settings, faculty and administrators. Developing effective partnership of students, faculty, and healthcare systems is a key solution in helping students develop and demonstrate DNP competencies, and nursing institutions and leadership should explore further ways to fortify these partnerships.

Doctor of nursing practice scholarship dissemination through an open access repository.

Open access repositories have become more widely used for the dissemination of Doctor of Nursing Practice (DNP) scholarly projects nationally and internationally. This article shares lessons learned from five years of experience with using an institutional repository, archiving and showcasing over 100 full-text DNP projects in the collection. The aims of this article are to examine the advantages of disseminating DNP scholarly projects through an Open Access (OA) repository and to explore how items archived in OA repositories complement traditional publishing models as supplementary parts of the research ecosystem. Items from the collection have been downloaded over 72,000 times at over 3700 institutions in 182 countries around the globe. Archiving DNP projects in an OA collection can improve health care practices by augmenting the dissemination of practice outcomes in traditional peer-reviewed literature. This article provides guidance for those looking to establish and evaluate similar collections, highlighting lessons learned.

Linking Process Improvement with DNP Projects: Strategies to Advance Clinical Leadership Initiatives

Nurse leaders are positioned to play a pivotal role in creating opportunities for Doctor of Nursing Practice (DNP) projects. A formal process was established at one university school of nursing to match more than 50 DNP students with projects identified by several organizational nurse leaders. The initiative has benefited organizations through the improvement of expanded or extended practice improvement projects and DNP students who have the opportunity to collaborate with leadership and interprofessional teams. This article highlights key strategies for nurse leaders to identify DNP project opportunities to advance clinical practice improvement and leadership initiatives.

Dissemination enhancement in Doctor of Nursing Practice students.

Students in Doctor of Nursing Practice (DNP) programs graduate with a completed DNP Project focused on practice improvement utilizing evidence-based research. Despite the value in disseminating the DNP Project outcomes to an audience of interest, many DNP graduates do not pursue dissemination beyond conclusion of their project and graduation. The DNP Project didactic course and the DNP Project manuscripts were revised with active learning assignments designed to improve knowledge, skills, and confidence in professional writing and dissemination. A cohort of 26 students was invited to participate in informal focus groups to determine impact of the revisions. The program director tracked the number of students accepted for conference presentations or manuscripts post-implementation. Of those invited to the focus groups, 25 students provided feedback. The students reported a perceived increase in competence and confidence in their ability to submit a professional abstract or manuscript for presentation or publication. Faculty noted an increase in the number of students who proceeded with dissemination of their DNP Project. Capturing the momentum for dissemination by revising the DNP Project didactic course and DNP Project manuscripts proved valuable for enhancing graduates disseminating professionally thus contributing to the translation of evidence-based practice into healthcare.

A Novel Approach to Fostering Academic-Practice Partnerships: The DNP Project Executive Summary.

Practice partnerships are vital to academic nursing for opportunities for robust student clinical experiences. The Doctor of Nursing Practice (DNP) scholarly project provides benefits for both students and practice partners; however, traditional academic dissemination methods such as student posters and publications are not internal communication formats used by practice partners. An assignment was developed for DNP students to write an executive summary of the completed scholarly project for their practice-partner organization stakeholders. Students used business writing skills to develop a one-page document summarizing the implementation and results of their project for a document applicable to the business of health care. Incorporating an executive summary of the DNP scholarly project emphasizes the value of student-led initiatives to organizations and can strengthen academic-practice partnerships. This innovative approach to dissemination of outcomes delivers a practical business communications document that is valuable to practice mentors and organizational leaders. [J Nurs Educ. 2022;61(3):156-158.].

Introducing the DNP Projects Department.

In 2004, to advance the credibility and education of the advanced practice nurse, member schools affiliated with the American Association of Colleges of Nursing (AACN) began a process to endorse a position statement on the practice doctorate in nursing. With this endorsement of advanced clinical practice nursing education at the doctoral level-an alternative to research-focused doctoral programs-the credential of doctor of nursing practice (DNP) began.

Managing DNP projects in student/faculty groups to facilitate learning with large cohorts.

Despite the initial intent of the 2004 American Association of Colleges of Nursing (AACN) position statement to move all advanced nursing practice education to the doctoral level, many schools remain at the master's degree level. Many schools successfully transitioned their programs but struggled with adequate resources for the growing number of students and the faculty, staff, and preceptor workload associated with the Doctor of Nursing Practice (DNP) project courses. The AACN 2015 taskforce made many recommendations related to quality of DNP projects, but there is little in the literature on best operational practices. The goal of this paper is to describe how one school modified the DNP project courses from a traditional chair and committee driven format to a class driven format with multiple smaller sections to successfully manage large numbers of DNP students across nine specialties. Specifically, a new model with its successes and challenges is described as well as details regarding finances, course coordination, project advisors, project team, annual offerings and grouping of students.

Strengthening the impact of Doctor of Nursing Practice projects in education and clinical practice.

The significance and value of Doctor of Nursing Practice (DNP) projects can be potentiated by collaboration between educators and practice leaders and when students build on previous DNP projects, as demonstrated in this article. Projects can have a longstanding financial, quality, and outcome impact, helping demonstrate the worth and efficacy of the DNP degree.