DNP Outcomes Survey 2010 Team

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1 Karen Crowley, DNP, APRN-BC, WHNP, ANP David G. O Dell, DNP, FNP-BC DNP Outcomes Survey Team Development Team: Stephanie Ahmed, DNP, FNP-BC Catherine S. Bishop, DNP, NP, AOCNP Karen Crowley, DNP, APRN-BC, WHNP, ANP Donald Grimes, DNP, RN Star Evangelista Hoffman, DNP, Med, CNL David G. O Dell, DNP, FNP-BC Marie G. Young, DNP, MPH, FNP, PMHNP 2 Compare DNP program curriculum as they relate to the AACN essentials Evaluate current practice trends of DNP graduates Identify future challenges and opportunities for DNP programs and DNP graduates 1

2 Annual DNP Outcomes Survey: Background Planned and developed by DNP, LLC / DNP PD, Inc. Goal is to determine the state of the practice of DNP graduates Disseminate at annual DNP conferences Two arms of this survey: 1. Graduates in practice 2. Current DNP programs 4 Award a degree that reflects the expert clinical competencies required by healthcare providers to meet the challenging healthcare needs of individuals and changing healthcare systems aacn.org 24 American Association of Colleges of Nursing (AACN) endorsed a position statement for the practice doctorate in nursing to be the educational preparation for the advanced practice registered nurse (APRN) 29 - Commission on Collegiate Nursing Education (CCNE) amended accreditation standards to require the AACN DNP essentials 215 AACN target goal date for the transition to the DNP for APRNs Position statement supported by the stake-holders indicating the DNP as the appropriate degree for APRN s Certifying organizations have not mandated a DNP degree as a requirement for certification aacn.org 2

3 Commission on Collegiate Nursing Education (CCNE) Accredited 68 DNP programs 7 additional DNP programs seeking accreditation National League for Nursing Accreditation (NLNAC) Five programs accredited for DNP One program seeking accreditation for DNP Foundational component: AACN Essentials Scientific underpinning of practice 2. Organizational and system leadership for quality improvement and systems thinking 3. Clinical scholarship and analytical methods for EBP 4. Information systems/technology and patient care technology for the improvement and transformation of health care 5. Health care policy for advocacy in health care 6. Inter-professional collaboration for improving patient and population health outcomes 7. Clinical prevention and population health for improving the nation s health 8. Advanced nursing practice Specialty component: required by national certification or specialty organizations aacn.org and Questions? 1) Are DNP programs offering the core curricular required to meet the degree competencies? 2) Are graduates of DNP programs utilizing these core competencies in practice? 9 3

4 1) Are DNP programs offering the core curricular required to meet the degree competencies? Methodology Program Evaluation Comparison of DNP programs Collected from Web-sites Confirmed with Institutions DNP Program Picture 131 DNP programs in the U.S. and District of Columbia 5,165 students enrolled in a practice focus doctorate 4, 177 students enrolled in a research focused doctorate 11 DNP Program Picture 154 DNP programs in the U.S. and District of Columbia 1 4

5 13 Enrollments for Practice vs. Research Focused Doctorates Practice Focused Research Focused aacn.org 14 6% 5% 4% 3% 2% 1% % Traditional Distant Hybrid 5

6 6.% 1.% 2.% 3.% 4.% 5.% 6.% 7.% 8.% 9.% 1.% MSN-DNP BSN-DNP BSN-DNP MSN-DNP Credit Hours Average BSN-DNP MSN-DNP: (24-9) Credit Hours Average BSN-DNP MSN-DNP Clinical Hours Average BSN- DNP MSN- DNP Clinical Hours Average

7 1.% 9.% 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% NP CNS CNM CRNA % 4.% 35.% 3.% 25.% 2.% 15.% 1.% 5.%.% No Role ID Nurse Executive Nurse Educator Health Policy Informatics 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% Health Policy Informatics Epidemiology Statistics Culture Popoluation Health Promotion Disease Prevention Electives 7

8 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% Practice Management Organizational Management Nursing Leadership 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% EB/Translational research Qualitative Combined Qual/ Quant Quantitative Hybrid Thesis/Dissertation Requirement Publication Requirement 8.% 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% Capstone Project Capstone Seminar Course DNP Practicum/Residency 8

9 Programs still in development but to a lesser degree More programs are being accredited Program development shifting to the BSN-DNP entry point Re-structuring of current programs Increase transparency of curriculum More focused specialty tracks (Policy, Leadership, informatics etc) Still wide variation on credit and clinical hours for each entry point Absence of core competencies in curriculum (culture, health promotion/disease prevention, policy, informatics, leadership) Publication becoming more a common requirement 2) Are graduates of DNP programs utilizing these core competencies in practice? DNP outcomes Quantitative Voluntary Electronic National Survey Data Collected: 4/14/11-8/15/ respondents Implied consent Missing Data Data Presentation 87% of the respondents had earned their practice doctorate, 13% in process of earning the degree Programs Competencies 9

10 4.% 35.% 3.% 25.% 2.% 15.% 1.% 5.%.% 25-3y 31-35y 36-4y 41-45y 46-5y 51-55y 56-6y 61-54y >66y 16.1% (n=58) 22.5% (n=81) 28.3% (n=12) 33.1% (n=119) North South Midwest West 6.% (n=2) 13.5% (n= 47) 2.4% (n=71) 74.4% (n=259) Clinical Leadership Education Other 1

11 1.% (n=31) 75.% 5.% (n=144) 25.% (n=68) (n=12).% Capstone Thesis/Dissertation Residency/clinical Article for Publication 6% (54.1% n=191) 5% 4% 3% 2% 1% % (21.2% n=75) (12.7% n=45) 5% (n=19) 5% (n=18) 1% (n=5) >1 23.8% (n=49) 34.5% (n=71) Yes No 41.7% (n=86) Not Applicable 11

12 17.2% (n=62) 21.1% (n=76) 31.1% (n=112) 3.6% (n=11) Northeast South Midwest West n= n= n= n= n= (n=164) 52 (n=91) 58.4 (n= n= n=16 Before DNP After DNP Change Translation/ Disseminate Business plans Policy Activity Informatics HP & DP n= n= n= n= n= n= 64) 29.1 n= 76) 32.4 n= n= n=158 Full Scope Translating EBP ID Practice Gaps Develop Practice guidelines Use EBP skills Before DNP After DNP Change 12

13 79.% n= % n=48 9.% 71.% n= % n=87 8.% 71.4% n=15 7.% 6.% 5.% 4.% 3.% 76.% n=62 87.% n= %n= % n=34 2.% 47.6% n=1 1.%.% -1.% National Nursing Org. State Nursing Org. State Policy Change National Policy Change Global Policy Change Before DNP After DNP Change Academic Promotion 85.4 n= n= n= n= n=41 34 n= n=15 Pub. EBP Guideline Pub. Integrative Review Pub.Research 66.7 n= n= n= 29 Pub. Case Study Prior to DNP After DNP Change Colleagues Nurse Physician Administrative Academic 13

14 n= n= n= n= n= n= n= n= n= n=9 62.7n= n= 28-2 APRN Executive Educator Informatician Policy/Legislation Researcher Prior to DNP After DNP Change n= n= n=118 5 n= n=142 1 n= n= n= Primary Care Acute Care LT Care Rehab Community 8.7 n= n= n= n= n= n=136 Public Health Academia Prior to DNP After DNP Change 189 respondents yielded 178 thoughts with 4 themes Role (n=124) Scope: leadership (12); policy (13); research (1); fullest capacity (9); no change (4); Confident: EBP/research (17); leadership (2); informatics (3); policy (2) overall (9); Role Confusion: MD (2); public (2) organizations (4) Respect/Value: Devalued academia (13); MD s (3); executives (5); nursing (1); higher respect MD s (8); patients (5), nursing (2) Salary (7) Education (n=19) Clinical (2); APRN (2); consistency/rigor (7); philosophical difference (3); regret (5) Professional growth/personal satisfaction (n=13) Opportunities (n=22) Academic (19); entrepreneurial (3) 14

15 74 Respondents yielded 69 suggestions with 4 themes emerging Practice (n=33) Difference in practice (11); geographical difference (1); improved patient outcomes (3); entrepreneurial (3); Clinical differences (5); specialty (3); advance scope of practice (3); articles published (1); position/role change (1); obstacles in practice (2) Education (n=15) DNP faculty for DNP programs (4); consistency in programs (1); specialization tracks vs. global tracks (1); combined APRN/Education (1); student expectations before and after education (1); satisfaction with program (1); recommendation of program (1); accreditation (1); job placement (1); marketing (1); changes or additions to program (1); capstone helpful (1) Role (n=19) Colleague perception(14) Academia (5); executives (2); public (2); providers (1); utilization of role (4); should DNP be required for practice (1); DNP exam (1); opportunities (1); role strain (1); doctor acceptable (1) Degree (n=11) Reason for obtaining degree (2); Incentives (9) Education More DNP moving to academic practice Present during re-structuring phase Address philosophical difference Address tenure advancement for DNP s Practice Scope of practice maximized, confidence in essential competencies to function as independent provider Utilizing EBP to change entrepreneurial practice Increase in practice Research Bridge the gap of research discovery and application and integration of scholarship Continued increase in publications Policy Decrease membership in State and National Nursing Organizations Practice Less health promotion and disease prevention Clinicians and Leaders: Where are they going? Increase in opportunities may negatively affect point of care clinicians and leaders. Education Maintaining practice expertise- can it be done in academia? Role Identify factors that result in the devaluing or misunderstanding of the DNP Degree. 15

16 Award a degree that reflects the expert clinical competencies required by healthcare providers to meet the challenging healthcare needs of individuals and changing healthcare systems aacn.org Does the utilization of these competencies improve patient outcomes? THANK YOU 16

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