Post-Masters DNP Application Packet

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1 Doctor of Nursing Practice Post-Masters DNP Application Packet Mailing address for completed application packet: Missouri State University Department of Nursing 901 S. National Ave. Springfield, MO Phone: (417) /2015

2 Dear Prospective Post-Masters DNP Student: The Department of Nursing appreciates your interest in the Post-Masters Doctor of Nursing Practice (DNP) program at Missouri State University (MSU). The University has been offering graduate programs since 1996, and we are pleased you are pursuing graduate education. Doctoral education provides nurses with many exciting and rewarding opportunities. Our DNP program is focused on community leadership to improve health disparities. The program is offered for full or part-time study for Masters prepared nurses in the following advanced practice specialties: Nurse Practitioner, Nurse Anesthesia, Nurse Midwifery, and Clinical Nurse Specialist. The department currently is pursuing CCNE accreditation for the DNP program. All graduate programs at MSU have been continuously accredited. The Department makes every attempt to accommodate the adult learner. The entire Post-Masters curriculum is online with two to three required on-campus visits for orientation and DNP project requirements during the program. Students are able to remain employed while completing the program. Grants and scholarships may be available to assist full-time students. Contact the Missouri State University Department of Nursing if you would like to find out more about our exciting programs and how we can help meet your career goals. Phone the Department of Nursing at or toll-free to request additional information. 04/2015

3 Missouri State University Post-Masters Doctor of Nursing Practice Application for Admission Date of Application: Full-Time Part-Time Part A Identification Information Mr. Mrs. Ms. Other * Social Security # Date of Birth Legal Name (on RN License): Last First Middle NameMaiden Preferred First Name:_ Name Suffix: (Jr, Sr, III, etc.) Address: (Street and Number) (City) (State) (Zip Code) State of Legal Residence: Primary Phone Number: - Home Mobile Work Secondary Phone Number: - Home Mobile Work ** Address:_ Citizenship: US Citizen International Permanent Resident/Resident Alien Non-citizens must apply to the International Student Services Office. Visa Status *Your Social Security Number is optional for the application, however if you are admitted it is required for grants, scholarships, and financial aid. **After submission of your application, check your often for important updates on the application process. 1

4 Part B Education and Specialization Information Please provide nursing degree information: Degree Name of Institution DATE Graduated BSN CUM GPA CCNE or ACEN (NLNAC) Accredited Yes/No MSN Post-Graduate Nursing Certificate Doctorate Other Degrees List your Advanced Practice specialization, certification, and expiration: Ex: Family Nurse Practitioner: ANCC Certified-Expires January Specialization:Certification: Exp Specialization:Certification: Exp Specialization:Certification: Exp Part C Professional Information I. Provide RN license for each state in which you hold a current license. State:License Number Expiration Date: Active Inactive State:License Number Expiration Date: Active Inactive State:License Number Expiration Date: Active Inactive State:License Number Expiration Date: Active Inactive 2

5 II. Have you ever had an action taken against your nursing license? Yes No If yes, please attach separate documentation explaining the situation and resolution including date of action. III. Have you ever been convicted of a felony, drug or alcohol offense, or action against another person? Yes No If yes, please attach separate documentation explaining the charge, offense, and resolution including date of action. IV. Are you currently employed in any of the following settings? (Please check all that apply) Community Health Center Migrant Health Center Homeless Health Care Public Housing Primary Care Rural Health Clinic State or Local Health Dept. National Health Service Corps Indian Health Service Federal Qualified Health Center Ambulatory Practice Sites Primary Care/Family Practice Physician Office None of the Above V. Curriculum Vitae (CV): Although a CV is required as part of the application, it is not a substitute for items on this application. Therefore, please do not reference the CV such as See CV etc. on this application. All blanks are required to be filled in. Attach a CV that includes the following information, in chronological order from most current to least current with dates: All higher education institutions attended, including degrees earned Nursing work experience (time on job indicated in months) o 1 year equivalent of full-time experience in nursing is required Other work experience Leadership experience Community service 3

6 Part D Scholarly Writing A scholarly essay is a required part of your application. The essay length is 500-1,000 words. The reference format for the writing the essay is the APA format. See the following text. American Psychological Association. (2010). Publication Manual of the American Psychological Association (6th ed.), Washington D.C. Your essay will be evaluated for scholarly writing style, content and APA format which will be utilized in the overall analysis of your application. Provide an essay that addresses the following topics: 1. You are applying to a Doctor of Nursing Practice Program. Compare and contrast this terminal degree with that of a Ph.D. in Nursing. a. It is recommended that you view the DNP materials on the American Association of Colleges of Nursing (AACN) website as a reference to your response for this question. You can find these at this link: 2. Describe your proposed DNP project and how it will impact health and healthcare disparities. Part E Interview Topics Be prepared to discuss the following interview discussion topics: 1. Discuss your vision of being a leader in healthcare 2. Describe your plan for completing requirements of a doctoral level program 3. Identify your career goals and how the DNP program will help you achieve these goals 4. Identify and describe a DNP project topic that fits MSU s focus on leadership in health and health disparities in a vulnerable population 4

7 Part F is Mandatory for the On Campus Orientation If accepted into the DNP program, I understand that a mandatory on campus orientation is required of all students in June. The dates will be included on your acceptance letter. I further understand that failure to attend this orientation will result in my administrative withdrawal from the DNP program. Signature _ Date Part G Statements of Release and Certification I authorize the release of information contained in this application to be used for the purpose of considering me for scholarship and traineeship funds and so that aggregate data concerning Missouri State University may be compiled. Signature _ Date I certify that the information provided is true and complete; I understand that withholding information requested, with the exception of information designated as optional, or giving false information may make me ineligible for admission and enrollment and may result in termination from the program. Signature _ Date 5

8 Missouri State University Post-Masters DNP APPLICATION CHECKLIST All required application items must be submitted together AT ONE TIME in a large envelope to the MSU Department of Nursing. Submit the application to the address on the front of this packet. Initial that you have submitted each item in ONE envelope in the following order: Application checklist with your initials indicating completion Completed Post-Masters DNP application Curriculum Vitae (See Requirements on page 3) Scholarly Writing Sample (See page 3) Evidence of current certification in an area of advanced nursing practice Copy of RN license verification from State Board of Nursing Website in every state for which an active license is held. Proof of negative Tuberculosis (TB) status (within 1 year, renewed yearly) or appropriate medical follow-up if positive Evidence of Tetanus (TD) Vaccination (within 10 years, renewed when expired) Evidence of Vaccination (Series of 3) for, or Immunity (by Titer) to, Hepatitis B Documented immunity to Measles, Mumps, and Rubella by Titer or MMR immunization as an Adult Varicella (Chicken Pox), evidence of Titer, or Immunization Series as an Adult 6

9 Evidence of Flu Vaccination (within 1 year, renewed yearly) Family Care Safety Registry Evidence of current CPR certification: American Heart Association BLS for Healthcare Providers Three recommendations from Healthcare Professionals with a Master s Degree or higher that can address the applicant s potential as a clinician, leader, and scholar using the standardized DNP reference form. Form available on MSU DNP Website $50 Non-Refundable Application Fee Pay Online at *Submit a copy of your paid receipt in your application packet Pre-requisites: Healthcare Informatics Course Institution Taken Date Multivariate Statistics Course Institution Taken Date Epidemiology Course Institution Taken Date 7

10 Technology and Proficiency Requirements By initialing below, you acknowledge that you are proficient or will become proficient by the start of the program in the following computer skills: Have access to a computer with an internet connection. Access to DSL or cable connections are required. Do not rely on corporate computers for this access as many times content will be blocked by a firewall. Have basic web search and browsing skills (know what browser you are using, understand how to open and close new browser windows or tabs, and understand how to override pop-up blockers) Have basic file management skills (create/locate/delete/move a file or folder on your computer) Understand various file formats (.doc,.docx,.pages,.wps, etc.) and able to follow instructions on the type of file preferred by your Instructor for the course. *Search for and obtain articles from online databases, the university library and inter-library loan. Be able to use Microsoft Office, iwork (Mac) or Open Office software to create documents, spreadsheets or presentations, edit them, save them, scan them, convert them to other formats as needed, print them and them as attachments or upload them to the *Blackboard *instruction provided in orientation 8

11 Items required for complete admission that are not part of the submission envelope: MSU graduate college application Items required for complete admission into DNP Program after acceptance: Proof of current NP Student Liability Insurance due on or before May 1. (minimum limits of $1,000,000 each occurrence and $6,000,000 aggregate) Insurance to begin June 1 st (renewed yearly) Proof of current Personal Health Insurance due on or before May 1 (must stay current while in the program) Bloodborne Pathogens, initially provide by May 1 (due annually in August or before clinicals, whichever occurs first) Submit Typhon clinical tracking fee (Approx. $80.00) Pay for and complete Background Check without disqualifications due on or before May 1. (you will be notified via when/where to go with instructions) Pay for and complete Urine Drug Screen without disqualifications due on or before May 1. (you will be notified via when/where to go with instructions) List of previous APRN clinical hours Please indicate how you heard about the DNP program at MSU. Website Friend DNP Brochure Other Please Specify 9

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