DNP-Essentials-Paper-FDL-DNP-summer-2017

This essential impacts DNP practice in regards to health care policy, clinical practice, and academia.. Preparation in organizational and systems leadership at every level is imperative

DNP Essentials Paper Jaime Berry Fort Hays State University

DNP Essentials Paper The doctor of nursing practice (DNP) is a demanding and challenging practice focused doctoral program DNP education focuses heavily on innovation and evidence-based practice (EBP), while translating research findings into the healthcare setting The DNP graduate

provides leadership and demonstrates competence in the translation of research into practice, while continuously evaluating new knowledge It is important that the DNP professional is well-versed in the EBP process and has a strong ability to lead and support others in providing

evidence-based care In 2006, the American Association of Colleges in Nursing (AACN)

published the Essentials of Doctoral Education for Advanced Nursing Practice These eight

essentials are the foundational competencies that articulate advanced nursing practice at the DNP level

DNP Essential I addresses the scientific underpinnings required for practice This

essential describes the scientific foundations of nursing practice, which are based on the natural and social sciences Chism (2016) states that nursing science has expanded the discipline of nursing and includes the development of middle-range nursing theories and concepts to guide practice According to the AACN (2006), the DNP degree prepares the graduate to do the

following: integrate nursing science with knowledge from the organizational, biophysical, psychological, and analytical sciences, as well as ethics, as the basis for the highest level of nursing practice in addition to utilizing science-based concepts and theories to determine the significance and nature of health and healthcare delivery phenomena, describe strategies used to enhance healthcare delivery, and evaluate outcomes This essential impacts DNP practice in regards to health care policy, clinical practice, and academia In order to achieve specific

healthcare goals within society, it is important for the DNP graduate to incorporate the scientific

foundations when developing health care policies By integrating nursing science with

knowledge, clinical practice will not only benefit the patients, but their families and the

community as well Advances in the foundational and nursing sciences will occur continuously, and nursing curricula must remain sensitive to emerging and new scientific findings to prepare the DNP for evolving practice realities (AACN, 2006)

Essential II evaluates organizational and systems leadership for quality improvement and

systems thinking Preparation in organizational and systems leadership at every level is

imperative for DNP graduates to have an impact on and improve healthcare delivery and patient care outcomes (Chism, 2006) In order to improve patient care and healthcare outcomes,

knowledge and skills in these areas will help to promote patient safety and target the needs of patients within the community of the healthcare provider Being able to evaluate the cost

effectiveness of care and use economics and finance to redesign effective and realistic care delivery strategies are vital as a DNP professional As stated by AACN (2006), the DNP

program prepares the graduate to develop and/or evaluate effective strategies for managing ethical dilemmas inherent in patient care, the health care organizations, and research This

Essential impacts the DNP practice role as it applies to health care policy, clinical practice

academia, and leadership According to Zaccagnini & White (2017), the DNP educator will be able to use the principles of business, finance, economics, and health policy to improve the delivery of the education, and he or she will have the advanced communication skills to lead such changes It is important for the DNP professional to have strong leadership skills in order

to make changes within health care policy as well as in the clinical setting Utilizing advanced communication skills will enable DNP leaders to initiate quality improvement and patient safety

initiatives in a healthcare delivery setting Being able to create and sustain measureable changes

to improve quality is what this essential is all about

Essential III focuses on clinical scholarship and analytical methods for evidence-based

practice The hallmarks of doctoral education include scholarship and research and how one can incorporate them into practice Chism (2016) goes on to say that DNP graduates are unique in that their contributions to nursing science involve the “translation of research into practice and the dissemination and integration of new knowledge.” As one is actively involved in nursing practice, this essential is one that will be with the DNP professional throughout their career In order to determine the best evidence for practice, one must continually evaluate existing

literature and other research They must then apply relevant findings and evaluate whether or not they improve quality in order to promote “safe, effective equitable, and patient-centered care”

(AACN, 2006) Essential III impacts practice in regards to health care policy, technology,

clinical practice, academia, and leadership Using scholarship and EBP impacts health care policy on many different levels The DNP professional must continually evaluate new research and apply it to current practice guidelines It is important for the DNP graduate to utilize

informatics and research methodologies to collect and analyze data, design databases, and

interpret findings to design evidence-based practice, which will improve the practice

environment (Chism, 2006) Strong leadership skills will allow the professional to influence health care policy changes in order to promote better patient outcomes, mentor other healthcare professionals about incorporating evidence-based research into clinical practice, and bring skills mastered in this essential into the academic setting Working collaboratively with others will not only foster future research, but promote the use of scholarship and evidence-based practice within the healthcare setting of the DNP professional

Essential IV concentrates on information systems-technology and patient care technology

for the improvement and transformation of healthcare According to AACN (2006), DNP

graduates are distinguished by their abilities to use information systems/technology to support and improve patient care and healthcare systems, and provide leadership within healthcare systems and/or academic settings Expertise is garnered in information technology, such as web-based communications, telemedicine, online documentation, and other unique healthcare

delivery methods (Chism, 2006) Proficiency in information technology systems allows the DNP professional to implement quality improvement initiatives and support decision-making within clinical practice and administrative positions In order to evaluate health care information systems and patient care technology, one must be able to critically analyze and communicate necessary elements to other healthcare professionals Zaccagnini & White (2017) describe that technology in education is an emerging tool for teaching and learning, and educators are rapidly learning how to leverage technology to improve education Not only will they be proficient in the use of technology for patient care but they will also bring that expertise into the academic environment as well Distance learning and online education is becoming more popular and the accepted norm in today’s ever-changing world This DNP essential impacts the DNP practice role in health care policy, clinical practice, academia, and leadership Clinical practice has definitely evolved with the implementation of information technology and patient care

technology With the use of online documentation and telemedicine, informatics in healthcare play a huge role within this DNP essential

Essential V discusses healthcare policy for advocacy in health care According to Chism

(2016), becoming involved in healthcare policy and advocacy has the potential to affect the delivery of health care across all settings Knowledge and skills related to healthcare policy are

central to nursing practice and are therefore essential to the DNP graduate “Health policy influences multiple care delivery issues, including health disparities, cultural sensitivity, ethics, the internalization of health care concerns, access to care, quality of care, health care financing, and issues of equity and social justice in the delivery of health care” (AACN, 2006) The DNP professional can be a strong advocate for healthcare policy based upon their clinical practice experiences This DNP essential impacts the DNP practice role in clinical practice, academia, and leadership roles According to the AACN (2006), the DNP graduate is prepared to provide the following: leadership in the development and implementation of healthcare policy at the institutional, local, state, federal, and international levels In addition, they can actively

participate in the education of other healthcare professionals, patients, or other stakeholders regarding healthcare policy issues The DNP graduate can act as an advocate for the nursing profession through activities related to healthcare policy as well as advocate for ethical,

equitable, and social justice policies across all healthcare settings

Essential VI focuses on interprofessional collaboration for improving patient and

population health outcomes This essential specifically relates to the Institute of Medicine’s (IOM) mandate to provide safe, timely, equitable, effective, efficient, and patient-centered care (Chism, 2016) In order for this essential to be met, healthcare professionals must function and collaborate among each other as a team Effective team leadership plays a major role when establishing intercollaboration among healthcare providers It is important for the DNP

professional to participate in the work of the team and assume the leadership role of the team if needed This DNP essential impacts the DNP practice role in clinical practice, academia, and leadership Zaccagnini & White (2017) report that the DNP-prepared nurse educator who has

mastered the sixth essential, will be ready to bring team leadership and collaboration to the academic arena

Essential VII evaluates clinical prevention and population health for improving the

nation’s health Anderson et al., (2015) discusses that the DNP graduate is described as having a foundation in clinical prevention and population health This foundation requires the ability to analyze scientific data, synthesize concepts, and develop/implement/evaluate interventions to address a continuum of care related to health promotion, disease prevention, and gaps in care One of the foundations of nursing include health promotion, while reducing healthcare

associated risks DNP graduates are in an ideal position to participate in health promotion and risk reduction activities from a nursing perspective with additional preparation in evaluating and interpreting data that are pertinent to improving the health status of individuals (AACN, 2006) Chism (2016) explains that the DNP curriculum will prepare graduates to “analyze

epidemiological, biostatistical, occupational, and environmental data in the development,

implementation, and evaluation of clinical prevention and population health.” This DNP

essential impacts the DNP practice role when developing health care policy, clinical practice, academia, and leadership The DNP professional plays a strong role in health promotion and disease prevention A strong role in this arena will allow the DNP graduate to assist in the development of health care policies and incorporate those into clinical practice

Essential VIII explores advanced practice nursing According to the AACN (2006), the

increased knowledge and sophistication of healthcare has resulted in the growth of specialization

in nursing in order to ensure competence in these highly complex areas of practice DNP

programs provide preparation within distinct specialties that require expertise, advanced

knowledge, and mastery in one area of nursing practice Anderson et al., (2015) describes that

the DNP is expected to demonstrate advanced levels of critical judgement, systems thinking, and accountability in providing evidence-based care to improve patient outcomes By utilizing the EBP process, the advance practice nurse is able to select appropriate interventions in order to provide the best care and improve patient outcomes The AACN expects that all DNP graduates demonstrate refined assessment skills and base practice on the application of biophysical,

psychosocial, behavioral, sociopolitical, cultural, economic, and nursing science as appropriate

in their area of specialization This DNP essential impacts the DNP practice role in regards to health care policy, technology, clinical practice, academia, and leadership Being able to

implement and evaluate therapeutic interventions based on nursing and other sciences allows the DNP professional to impact clinical practice and academia Participating in therapeutic

relationships with patients and other healthcare professionals to ensure optimal patient care and improve patient outcomes allows the DNP professional to impact health care policy, clinical practice, academia, and leadership Utilizing advanced clinical decision-making skills and critical thinking, allows the DNP professional to deliver and evaluate evidence-based care to improve patient outcomes and allows the DNP professional to impact health care policy, clinical practice, academia, and leadership Serving as a mentor to others within the profession impacts the profession in clinical practice and leadership

In conclusion, the AACN published The Essentials of Doctoral Education for

Advanced Nursing Practice in 2006 The DNP Essentials document outlines and defines the

eight foundational essentials for DNP graduates The DNP graduate provides leadership and demonstrates competence in the translation of research into practice, while continuously

evaluating new knowledge These competencies are deemed essential for all graduates of a DNP program regardless of specialty or functional focus

American Association of Colleges of Nursing (2006) In The essentials of doctoral education

for advanced nursing practice Washington, DC: Advancing Higher Education in

Nursing

Anderson, B A., Knestrick, J M., & Barroso, R (2015) DNP Capstone Projects New York,

NY: Springer Publishing Company

Chism, L A (2016) The doctor of nursing practice: a guidebook for role development and

professional issues (3rd ed.) Burlington, MA: Jones & Bartlett Learning.

Zaccagnini, M E., & White, K W (2017) The doctor of nursing practice essentials: a new

model for advanced practice nursing (3rd ed.) Burlington, MA: Jones & Bartlett

Learning