NURS 8002 Weeks 4–5 Discussion: AACN Essentials for the Doctorally Prepared Nurse -

NURS 8002 Weeks 4–5 Discussion: AACN Essentials for the Doctorally Prepared Nurse

NURS 8002 Weeks 4–5 Discussion AACN Essentials for the Doctorally Prepared Nurse

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Weeks 4–5: AACN Essentials for the Doctorally Prepared Nurse

[The AACN DNP] Essentials outline the foundational competencies that are core to all advanced practice roles, including the four nationally-recognized Advanced Practice Registered Nursing roles: nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives.
— American Association of Colleges of Nursing (2006)

What does it mean to be a DNP-prepared nurse? What core function of advanced nursing practice do you hope to practice upon completion of your DNP? How will earning a DNP enhance your nursing practice?

Questions such as these may represent some underlying consideration that led you to pursue a DNP. In your role as a DNP-prepared nurse, you will likely be called upon to perform advanced nursing practice skills that not only enhance patient care but will impact the delivery of healthcare, organizational standards, and quality improvement initiatives.

This week, you consider the role of a nurse with a practice doctorate, including the expectations associated with obtaining a DNP degree. You reflect on your personal motivations for pursuing a doctoral degree and begin to examine how your proposed Doctoral Project and practicum/field experience will align to the AACN DNP Essentials.

_{Reference:

American Association of Colleges of Nursing. (2006). DNP essentials. https://www.aacnnursing.org/DNP/DNP-Essentials}

Learning Objectives

Students will:

Analyze the role of a nurse with a practice doctorate
Analyze expectations associated with obtaining the DNP degree
Analyze personal motivations for pursing a doctoral degree
Explain the role of the DNP-prepared nurse in meeting organizational quality improvement needs
Evaluate alignment between the AACN DNP Essentials and completion of Doctoral Projects
Evaluate alignment between the AACN DNP Essentials and completion of a practicum/field experience

Learning Resources

Required Readings (click to expand/reduce)

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Beeber, A. S., Palmer, C., Waldrop, J., Lynn, M. R., & Jones, C. B. (2019). The role of Doctor of Nursing Practice-prepared nurses in practice settings. Nursing Outlook, 67(4), 354–364. https://doi.org/10.1016/j.outlook.2019.02.006

Falkenberg-Olson, A. C. (2019). Research translation and the evolving PhD and DNP practice roles: A collaborative call for nurse practitioners. Journal of the American

Association of Nurse Practitioners, 31(8), 447–453. https://doi.org/10.1097/JXX.0000000000000266

Fiset, V. J., Davies, B. L, Graham, I. D., Gifford, W., & Woodend, K. (2019). Developing guideline-based quality indicators: Assessing gaps in pain management practice.

International Journal of Evidence-Based Healthcare, 17(2), 92–105. https://doi.org/10.1097/XEB.0000000000000160

Giardino, E. R., & Hickey, J. V. (2020). Doctor of Nursing Practice students’ perceptions of professional change through the DNP program. Journal of Professional Nursing, 36(6), 595–603. https://doi.org/10.1016/j.profnurs.2020.08.012

Hartjes, T. M., Lester, D., Arasi-Ruddock, L., McFadden Bradley, S., Munro, S., & Cowan, L. (2019). Answering the question: Is the Doctor of Philosophy or Doctor of Nursing

Practice right for me? Journal of the American Association of Nurse Practitioners, 31(8), 439–442. https://doi.org/10.1097/JXX.0000000000000273

Rew, L., Cauvin, S., Cengiz, A., Pretorius, K., & Johnson, K. (2020). Application of project management tools and techniques to support nursing intervention research. Nursing Outlook, 68(4), 396–405. https://doi.org/10.1016/j.outlook.2020.01.007

Tussing, T., Brinkman, B., Francis, D., Hixon, B., Labardee, R., & Chipps, E. (2018). The impact of the Doctorate of Nursing practice nurse in a hospital setting. The Journal of Nursing Administration, 48(12), 600–602. https://doi.org/10.1097/NNA.0000000000000688

Walden University. (n.d.). Field experience: College of nursing. Field Experience. https://academicguides.waldenu.edu/fieldexperience/son

Document: DNP Project Process Guide (Word document)

Discussion: The Doctoral Degree and Professional Nursing Practice

A doctoral degree carries a certain set of expectations associated with the completion of advanced educational attainment. Earning a DNP degree is no exception. What are the expectations associated with a DNP-prepared nurse? How might these expectations differ among nursing staff without a DNP degree?

The role of a DNP-prepared nurse is multifaceted; they can serve as nurse educators, policy and legislation advocates, direct nursing care supervisors, or advanced practice nurses responsible for tracking, installing, and monitoring initiatives aimed at improving nursing and healthcare delivery. Regardless of the expectations associated with a DNP-prepared nurse, throughout your program of study, you will hone the skills necessary to enact each of these roles. Consider which role you are most excited about. What do you hope to accomplish in the realm of professional nursing practice with your DNP degree?

For this Discussion, reflect on your personal motivations to pursue a DNP degree. Consider the expectations associated with the DNP-prepared nurse, including how these may differ with a PhD-prepared nurse. Reflect on the DNP degree requirements, including your practicum/field experience and completion of your Doctoral Project. Then, think about how you will demonstrate the alignment of the AACN DNP Essentials to the completion of these program-of-study milestones.

To prepare:

- Review the Learning Resources and reflect on the reasons you have chosen to pursue a DNP degree. How do you anticipate that earning this degree will support your professional goals?
- Reflect on the differences between DNP and PhD degrees. How may this relate to your decision to pursue the DNP degree?
- Review the degree requirements for completing your DNP at Walden. Specifically, consider the focus of the Doctoral Project and practicum experiences as discussed in the DNP Essentials document. Keep in mind that you will be required to identify a site or sites for completion of your DNP project and your practicum hours required for the degree. You can refer to the Field Experience requirements presented in the Learning Resources.

Photo Credit: Creativa Images / Adobe Stock

After reviewing the DNP Essentials document and the DNP Project Process Guide for the DNP project, reflect on what it means to address an organization’s needs to attend to a gap in practice or implement a practice change. What is the difference between a gap in practice and a practice change? How does your role as the DNP-prepared nurse contribute to meeting a stakeholder need?

By Day 3 of Week 4

Post a brief explanation of the role of the nurse with a practice doctorate. Be specific. Explain the expectations associated with obtaining this degree, including how these expectations might be different for a nurse who holds a different degree. Then, explain how these considerations relate to your motivation to pursue a DNP, including a brief description of how your role as a DNP-prepared nurse will meet a potential organization’s need to address a gap in practice or implement a practice change. Discuss any experiences you have had in addressing a gap in practice or a practice change within an organization. Be specific.

By Day 6 of Week 4

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting an additional perspective on what it means to be a nurse with a practice doctorate, offer support to the expectations with obtaining the degree that your colleague posted, or expand upon your colleague’s post.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Why DNP

COLLAPSE

There are two routes to go to achieve the highest levels in nursing. One track is to get a PhD which is research based and tends to lend itself to a career in research or education (Gaines, 2019). Many nurse educators at the Masters level require a doctorate and of course to teach doctorate nurses that is required. The PhD nurse does not often work in clinical settings and while the degree often takes longer to receive, the PhD does not need renewal. The DNP nurse is based in clinical practice. There are many articles that discuss how there is a lack of definition with regard to the exact purpose of the DNP and that more studies are needed to determine what they do most often but there are some generalities. They often act as advanced practice nurses at the bedside, working as providers to patients or they hold leadership roles in hospital systems such as chief nursing officers (Beeber, Jones, Palmer, Waldrop, Lynn, 2016).

In order to receive a PhD one must complete three to four years full time with the education being primarily online, however students are expected to be on campus for specific events such as their dissertation and defenses. The dissertation is a research based final project that all students of a PhD program must complete and successfully defend. In a DNP program, it can be completed in three years, post bachelor and two or sometimes less if the student already has a masters. However, while it is shorter, these students must obtain clinical hours and they must create and carry out a quality improvement project.

I understand the challenges that will come with attempting to obtain a nursing degree of the highest level but I want to make a bigger difference. That is why I am doing this. I have interest in all areas of nursing but especially in mental health and the emergency department which often blends together very closely. I do want to do patient care, I enjoy patient interactions and helping people on an individual level. I do not see myself ever giving that up completely. I also think I will continue teaching in some capacity, although probably only part time. I truly want to implement some upper level changes though. I already have been working on my quality improvement project which is based in the departments I said I enjoy, the ED and mental health. Too often, I see nurses outside of mental health units not knowing how to treat patients with mental illness and it often leads to injuries and/or unnecessary restraints. I want to implement crisis prevention intervention (CPI) training throughout an emergency department and see if those injuries and restraint numbers go down. It would be safer for the staff and lead to better patient care and outcomes. Previously, I have done a training in a few hospitals with my mother, the ED nurse, regarding these ideas of improved patient care of the mental health client in non-mental health environments and it has seemingly been well-received.

References

Beeber, A., Jones, C., Palmer, C., Waldrop, J., & Lynn, M. 2016. Determining the role of the nurse with a doctor of nursing practice degree. Research Brief. Retrieved from https://www.shepscenter.unc.edu/wp-content/uploads/2016/12/ResearchBrief_DNP_Beeber_final.pdf

Gaines, K. 2019. Dnp vs phd in nursing- what is the difference? Education. Retrieved from https://nurse.org/education/dnp-or-phd-in-nursing-difference/

RE: Why DNP

COLLAPSE

I just wanted to re-iterate you are on the right track. To become a nurse educator, a graduate degree is required in nearly all circumstances. The least degree is a masters but the terminal degree Doctor of Nursing Practice (DNP) or Doctor of Nursing Philosophy (PhD) is preferred in most cases. You would be qualified to teach at a university or college to prepare the next generation of nurses to enter the profession.

Reference:

Nurse Educator Education Requirements: What Degree do I Need to Teach Nursing? ECPI university. (n.d.). Retrieved from https://www.ecpi.edu/blog/nurse-educator-education-requirements-what-degree-do-I-need-to-teach-nursing#:~:text=A%20nurse%20educator%20is%20a%20Registered%20Nurse%20%28RN%29,as%20imparting%20academic%20and%20technical%20information%2C%20nurse%20educators%3A

RE: Why DNP

COLLAPSE

You are exactly right. Nurses outside of mental health tend to not know how to handle patients with mental illness in its acute form. I remember my first acutely mentally ill patient in the ICU. I (we) did not know what to do. He was placed in 4-point leather restraints. When I think back on that time now, I feel horrible that we didn’t do a better job of taking care of him.

I applaud you for wanting to implementing crisis prevention intervention training in the emergency department to improve patient outcomes in nonmental health settings. Perhaps, it could eventually spread throughout the hospital as well. From my experience, it is needed and necessary. And as a DNP-prepared nurse, you will have acquired the skills necessary to be successful at implementing such change (American Association of Colleges of Nursing, 2006).

Employers have identified DNP-prepared nurses as leaders, having a positive impact on patient outcomes, as role models, and improving organizational systems by introducing more effective care delivery models (Beeber, Palmer, Waldrop, Lynn, & Jones, 2019)

References

American Association of Colleges of Nursing. (2006, October). The Essentials of Doctoral Education for Advanced Nursing Practic. Advancing Higher Education in Nursing. Washington, DC: DNP Essentials Task Force. http://www.aacn.nche.edu

Beeber, A. S., Palmer, C., Waldrop, J., Lynn, M. R., & Jones, C. B. (2019). The role of Doctor of Nursing Practice-prepared nurses in practice settings. Nursing Outlook, 354-364. https://doi.org/10.1016/j.outlook.2019.02.006

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Higher education attainment has been associated with enhanced competency and knowledge within the specific field pursued by an individual. For instance, attainment of a doctoral degree is considered the highest attainment in every field, and therefore doctoral degree holders are expected to demonstrate a high degree of competence (Dos Santos & Lo, 2018). A DNP-prepared nurse is no exception and is expected of higher levels of knowledge and competency in patient care as compared to nurses without the DNP. This week’s discussion explores doctoral degrees and professional nursing practice. To accomplish the discussion, the role of a nurse with a practice doctorate and the associated expectations will be discussed. In addition, this discussion will explore how the consideration relates to my motivation to pursue a DNP and an experience with addressing practice change or gap in practice.

Role of a Nurse with a Practice Doctorate

DNP-prepared nurses have various advanced roles in the continuum of patient care. For instance, through the translation of quality improvement outcomes, and translation of evidence into clinical areas, and unique practice innovations, the DNP-prepared nurses create new knowledge (Trautman et al., 2018). The implication is that these nurses apply evidence-based research to systems and/or clinical settings for better health outcomes. They practice at the highest level of practice and formulate evidence-based strategies to optimize health and patient outcomes. In addition, DNP-prepared nurses also take executive and leadership positions in healthcare organizations to influence health policies, analyze cost-effective protocols, direct patient care, and coordinate quality improvement teams.

Expectations Associated With Obtaining DNP

DNP is the highest degree in nursing and is associated with various expectations. Those who have obtained the degree are expected to show high levels of skills in the care environment to effectively direct care and coordinate care teams. As opposed to PhDs holders who mainly focus on research, DNP is associated with improvement of patient care and population outcomes (Edwards et al., 2018). The implication is that these nurses with this degree have adequate skills for implementing evidence-based strategies to improve health outcomes for individual patients and the general population. Nurse practitioners who do not have a DNP offer specializations focusing on particular patient care aspects like a pediatric or family practitioner. This role differs from a DNP prepared nurse as they are expected to step up to more advanced roles that help shape the direction of healthcare organizations.

How The Considerations Relate to My Motivation to Pursue a DNP

Growing up, I have had a passion for seeing everyone lead a healthy life devoid of health complications. While doing my undergraduate degree, I realized that such goals cannot be achieved by solely focusing on what happens in the care environment but also what happens in the surroundings, such as policies and funding. One of my motivations to pursue a DNP is to get to executive and leadership positions where I can participate in effectively influencing healthcare policies and decisions. As such, the role of the DNP-prepared nurse resonates and relates well with my motivation. Translating research evidence into clinical practice also helps in improving patient outcomes (Trautman et al., 2018), which is among my motivations for pursuing a DNP. Indeed, with a higher degree, I believe I will accomplish such a goal more efficiently.

Among the top organization needs is to be leaders in providing improved patient care and enhance the patient experience. Improving the quality outcome to enhance patient experience requires that the healthcare organization addresses the quality gaps (Trautman et al., 2018). As such, my role as a DNP-prepared nurse will help in various ways to such effect. For instance, in assuming the leadership roles of leading and coordinating care teams, I will be able to effectively lead other nurses into a careful analysis of quality data, organizational standards, and government standards to identify gaps in practice. This will lead to a formulation of the most relevant and effective strategies to address such gaps and meet the goals. Besides, I will also be able to lead the organization into a literature search for evidence that can be translated into practice to address practice gaps or lead a practice change for patient quality improvement.

The experience I have Had With How our Organization addressed a Practice Change

Organizations usually strive to achieve the central aim of offering patient optimized and improved patient care. As such, organizations either undertake steps to implement a practice change or address a gap in practice (Yip et al., 2019). I have had experience with the implementation of practice change within an organization. In one of the healthcare organizations, I have worked. There was a year where the rates of catheter-associated urinary tract infections were growing month after month. A decision was then made to explore initiatives to deal with the threatening growing rates of infection. One of the chosen strategies was using a protocol to evaluate patients and use the indwelling catheters only when it is a must and ensuring that the time of usage of the catheters by the patients be reduced to as minimum as possible. As such, nurses accomplished a comprehensive one-week training on the protocols. After the training, the catheter use rates reduced by 20% as nurses were able to avoid unnecessary catheterization. Coupled by minimizing the duration of catheter use, the rates of infection dropped by an impressive 47% by the second month due to the practice change.

Conclusion

In conclusion, the doctoral degree prepares individuals for greater and more advanced professional roles. DNP-prepared nurses have a special role to play in the care environment, one of which is translating evidence into practice for improved patient outcomes. This week’s discussion has covered the roles of a DNP-prepared nurse, expectations associated with DNP, and an experience with a practice change implementation.

References

Dos Santos, L. M., & Lo, H. F. (2018). The Development of Doctoral Degree Curriculum in England: Perspectives from Professional Doctoral Degree Graduates. International Journal of Education Policy and Leadership, 13(6), n6. https://doi.org/10.22230/ijepl.2018v13n6a781.

Edwards, N. E., Coddington, J., Erler, C., & Kirkpatrick, J. (2018). The Impact of the Role of Doctor of Nursing PracticeNurses on Healthcare and Leadership. Medical Research Archives, 6(4). https://doi.org/10.18103/mra.v6i4.1734

Trautman, D. E., Idzik, S., Hammersla, M., & Rosseter, R. (2018). Advancing scholarship through translational research: The role of PhD and DNP prepared nurses. Online Journal of Issues in Nursing, 23(2). DOI: 10.3912/OJIN.Vol23No02Man02.

Yip, W., Fu, H., Chen, A. T., Zhai, T., Jian, W., Xu, R., … & Chen, W. (2019). 10 years of healthcare reform in China: progress and gaps in universal health coverage. The Lancet, 394(10204), 1192-1204. https://doi.org/10.1016/S0140-6736(19)32136-1