The Doctor of Nursing Practice: A Report on Progress. C. Fay Raines, PhD, RN President American Association of Colleges of Nursing March 21, 2010

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1 The Doctor of Nursing Practice: A Report on Progress C. Fay Raines, PhD, RN President American Association of Colleges of Nursing March 21, 2010

2 Creating the Future The movement to the DNP is about producing the most competent nursing clinicians possible to meet the nation s healthcare needs. AACN has always advocated that education makes a difference in clinical practice. AACN members understand the mandate for change less than 1% of nurses in the U.S. have doctoral preparation. Raising educational expectations is common across professions striving for excellence.

3 AACN Members Endorse the DNP October 2004, strong majority vote to endorse the Position Statement on the Practice Doctorate in Nursing. Members approved a target goal for transition of APRN programs by Position developed through dialogue with an array of stakeholders and opportunities for comment. Position identified the DNP as the appropriate degree for advanced nursing practice.

4 Facilitating the Transition Two AACN Task Forces created: Task Force on the DNP Essentials Task Force on the Roadmap to the DNP April 2009, CCNE amended standards to require DNP Essentials CCNE evaluating and accrediting DNP programs CCNE has accredited 18 DNP programs; 70 additional DNP programs are pursuing CCNE accreditation

5 Organizational Responses American Association of Nurse Anesthetists Council on Accreditation will not accredit new master s programs for nurse anesthesia after Mandate that all CRNA programs transition to the practice doctorate by All new CRNA grads must hold a practice doctorate by 2025 to be eligible for certification. The Nurse Practitioner Coalition Statement 7 NP organizations (AANP, ACNP, AFPNP, NCGNP, NONPF, NPWH, NPNP): the DNP degree more accurately reflects current clinical competencies and includes preparation for the changing healthcare system.

6 Organizational Responses National Organization of Nurse Practitioner Faculties Endorsed the DNP and developed competencies for NP practice at the doctoral level. National Association of Clinical Nurse Specialists Neutral position on the DNP; has developed DNP level competencies for CNS graduates. American College of Nurse Midwives Recognizes the DNP as an option for some midwifery programs.

7 Changes in CMS Reimbursement AACN successfully advocated for CMS to change the regulatory language regarding reimbursement for APRN services from requiring nurses to hold a master s degree to holding a graduate degree in nursing. This important language change removed any potential barriers to DNP prepared nurses seeking reimbursement for their services.

8 DNP Program Evolution At the midway point to the 2015 goal, Schools of Nursing have made great progress in transitioning to the DNP. According to the 2009 AACN Annual Survey, 120 DNP programs are currently enrolling students, with programs now available in 36 states and the District of Columbia. As expected, student enrollment in and graduations from DNP programs has increased substantially over the last five years.

9 DNP Enrollments & Graduations 6,000 5,000 Enrollments Graduations 5,165 4,000 3,415 3,000 2,000 1, , Programs: Response: 100% 100% 100% 100% 100% 100% 100% 99.2%

11 Evolution & Challenges AACN recognizes that the transition to the DNP is challenging for some schools. We are grateful to those who have shared their concerns with us, since this will help to clarify next steps as the transition moves forward. Several concerns and questions have been raised: How do I transition my master s s level APRN program to the DNP? How can we do this by 2015 with insufficient financial resources and faculty? Will moving to the DNP reduce the production of APRNs at my school and in my state?

12 Evolution & Challenges Concerns and questions raised: Will employers want to hire DNP graduates versus master s s prepared APRNs? How can my school do this given state regulations? Concern that we need clarity about grandfathering current MSN prepared APRNs.. (This concern was also raised when NP education moved from the certificate to the master s s level preparation.)

13 Strategic Planning January 2010 Purpose: To assess the progress toward the DNP To identify next steps to address identified challenges Reviewed multiple sources of information: Current data on # of DNP programs, enrollment, and graduations Positions taken by other nursing organizations Feedback from the Master s Essentials Regional Meetings Market response to the DNP from employers and students Feedback from members

14 Strategic Planning January 2010 Based on the strong response to the DNP from AACN members and stakeholders, the Board reaffirmed its support for the member position on the DNP and the 2015 goal. Board recognizes challenges to this transition must be addressed. Will commit resources to develop tools, best practice resources, templates. Will facilitate consultation to schools seeking advice and exemplars. Will advocate for the DNP with policy makers and certifying bodies.

15 DNP Data Collection The Board asked for additional data from schools with APRN programs in relation to the DNP to better assess transition plans and identify support needed by schools. AACN conducted three surveys in February and March 2010 targeted to schools in the following categories: Schools with APRN programs and no previously expressed plans to start a DNP program Schools with APRN focused DNP programs, but no postbaccalaureate entry options Schools with APRN programs that are planning a DNP program

16 Survey Results When combined with AACN s 2009 annual survey data, the following results were found: 72% of schools with APRN programs (388 schools) are either offering (120) or planning (161) a DNP program. 62% of schools either offering or planning a DNP program (281) are planning to offer a postbaccalaureate entry option.

17 Survey Results The surveys asked schools to identify their greatest challenges to opening a DNP program. Responses included: Insufficient faculty Limited financial resources State regulations Lack of faculty support When asked why some schools were NOT closing their post master s APRN programs, responders cited: Strong interest from students in post MSN option Regulatory requirements Concerns about a possible drop in enrollments Faculty reluctance

18 Survey Results In all three supplemental surveys, AACN asked what resources were needed by schools looking to transition. Among the resources mentioned were: Program development guidance; sample curriculum Examples of capstone projects Advocacy support at the state level Faculty development Partnership models Referrals to consultants Advice on managing costs and maintaining enrollments Planning and program evaluation tools

19 Next Steps AACN will work to address the needs identified through the surveys. Two Webinars planned this spring with DNP leaders to provide expert insights and solutions to schools in transition. Will identify consultants and disseminate information on best practices. Will provide faculty development; highlight examples of capstone projects and curriculum models. Will work to develop models of collaborative/joint degree programs.

20 AACN Resources for DNP Transition While AACN works to develop new resources for members, some tools are available: DNP Roadmap Report DNP Tool Kit: Template for the Process of Developing a DNP Program DNP FAQs & Talking Points

21 Next Steps AACN will seek best practices and advice from your insights and experiences. Schools are encouraged to leverage their influence with policy makers, students, employers, and other stakeholders to advocate for the DNP. AACN will continue to identify challenges and address issues of importance in our transition to the DNP.

22 This is about creating the future for our patients and our profession.

Doctor of Nursing Practice Progress and Opportunities for the Future

Doctor of Nursing Practice Progress and Opportunities for the Future C. Fay Raines, PhD, RN Dean, College of Nursing University of Alabama in Huntsville Past President, American Association of Colleges