Board of Governors, State University System of Florida

Transcription

1 Board of Governors, State University System of Florida Request to Offer a New Doctor of Nursing Practice (DNP) Degree Program Florida Gulf Coast University August 2015 University Submitting Proposal Proposed Implementation Term College of Health Professions and Social Work Name of College Nursing Academic Specialty or Field School of Nursing Name of Department(s)/ Division(s) Doctor of Nursing Practice Complete Name of Degree Proposed CIP Code The submission of this proposal constitutes a commitment by the university that, if the proposal is approved, the necessary financial resources and the criteria for establishing new programs have been met prior to the initiation of the program. Date Approved by the University Board of Trustees President Date Signature of Chair, Board of Trustees Date Vice President for Academic Affairs Date Provide headcount (HC) and full-time equivalent (FTE) student estimates of majors for Years 1 through 5. HC and FTE estimates should be identical to those in Table 1 in Appendix A. Indicate the program costs for the first and the fifth years of implementation as shown in the appropriate columns in Table 2 in Appendix A. Calculate an Educational and General (E&G) cost per FTE for Years 1 and 5 (Total E&G divided by FTE). Implementation Timeframe Projected Enrollment (From Table 1) HC FTE E&G Cost per FTE Projected Program Costs (From Table 2) E&G Funds Contract & Grants Funds Auxili ary Funds Total Cost Year $15,775 $315, $315,500 Year Year Year Year $8,411 $988, $988,250 1

2 Note: This outline and the questions pertaining to each section must be reproduced within the body of the proposal to ensure that all sections have been satisfactorily addressed. Tables 1 through 4 are to be included as Appendix A and not reproduced within the body of the proposals because this often causes errors in the automatic calculations. Introduction I. Program Description and Relationship to System-Level Goals A. Briefly describe within a few paragraphs the degree program under consideration, including (a) level; (b) emphases, including concentrations, tracks, or specializations; (c) total number of credit hours; and (d) overall purpose, including examples of employment or education opportunities that may be available to program graduates. The proposed Doctor of Nursing Practice (DNP) Program at Florida Gulf Coast University (FGCU) will prepare graduates with the advanced nursing knowledge and leadership skills to improve health care outcomes and to provide expert evidence-based nursing care across diverse healthcare settings and systems. The FGCU DNP Program will be available as both the Master of Science in Nursing (MSN) to DNP Major (Postmaster s Entry) and the Bachelor of Science in Nursing (BSN) to DNP Major (Post-baccalaureate Entry). The DNP Program will include both full-time and part-time plans of study to meet the needs of working nurses in the FGCU service area. Approval of this proposal will result in the eventual sun setting of the current Primary Health Care Nurse Practitioner MSN program at FGCU. The FGCU MSN to DNP will be available to candidates who have already completed a Master s degree in nursing from a nationally accredited nursing program regardless of specialty practice area. The MSN to DNP will include required credits for DNP course work, practice hours, and the capstone project. The MSN to DNP builds upon the candidate s specialty practice area through a DNP core that focuses on utilization of research in the practice setting, quality of care delivery, examination of health care outcomes, leadership in practice, and fundamentals of nurse education. The total credit hours required for the MSN to DNP will be 39 credit hours. The FGCU BSN to DNP will be available for specialization as Nurse Practitioner with a concentration as either a Family Nurse Practitioner or an Adult-Gerontology Primary Care Nurse Practitioner. The program will offer specialty practice studies leading to eligibility as a certified Family Nurse Practitioner or Adult-Gerontology Primary Care Nurse Practitioner. The BSN to DNP studies also include the DNP core that focuses utilization of research in the practice setting, quality of care delivery, examination of health care outcomes, leadership in practice, and fundamentals of nurse education. The total credit hours required for the Nurse Practitioner BSN to DNP major is 84. Forecasts for employment of graduates from a DNP program are strong. Employment opportunities include medical practices, hospitals, community health agencies, primary care clinics, and schools of nursing. The Bureau of Labor Statistics outlook forecasts that advanced practice specialties will be in high demand, particularly in medically underserved areas such as inner cities and rural areas. DNP graduates can also help relieve the national nursing faculty shortage. The American Association of Colleges of Nursing (AACN) Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing identified that two-thirds of the nursing schools responding to the survey pointed to faculty shortages as a reason for not accepting all qualified applicants into programs. 2

3 B. Describe how the proposed program is consistent with the current State University System (SUS) Strategic Planning Goals. Identify which specific goals the program will directly support and which goals the program will indirectly support. (See the SUS Strategic Plan at The proposed DNP program is consistent with the three critical areas of focus for the State University System (SUS) of Florida 2025 goals related to teaching, research, and public service and the mission of FGCU. The program will directly support the following goals of the SUS of Florida: 1) strengthen quality and reputation of academic programs and universities, 2) meeting statewide professional and workforce needs, 3) building world-class academic programs and research capacity, and 4) meeting community needs and fulfilling unique institutional responsibilities. The proposed DNP program will increase the number of graduate nursing degrees conferred by FGCU. As the only SUS DNP program in Southwest Florida the proposed FGCU DNP program will provide access to doctoral nursing education for advanced practice nurses who live in the FGCU five county service areas. Doctorally prepared advanced practice nurses can help alleviate the nursing faculty shortage that is a major factor in the on-going Florida nursing shortage. Moving advanced practice nursing education to the doctoral level will result in higher quality health care and an increased capacity for evidence-based practice needed by the nursing profession. DNP graduates are uniquely prepared to help alleviate shortages of advanced practice nurses in both practice and educational settings. Similar to the goals of the SUS, the mission of FGCU is to fulfill the academic, cultural, social, and career expectations of its constituents. Graduates of the DNP program will improve the quality of health care, increase the pool of potential nursing faculty members, nurse executive leaders, and provide graduates with multiple employment options as advanced practice nurses. Institutional and State Level Accountability C. If the program is to be included in an Area of Programmatic Strategic Emphasis as described in the SUS Strategic Plan, please indicate the category and the justification for inclusion. The Areas of Strategic Emphasis: 1. Increase the number of degrees awarded in STEM and other areas of strategic emphasis 2. Increase collaboration and external support for research activity 3. Increase community and business workforce The SUS has designated several disciplines as critical to the service and infrastructure needs within Florida. One such discipline is Nursing. The current national shortage of nurses presents challenges to Florida s institutions as they work to prepare qualified individuals to meet current and projected nurse shortages. One pivotal obstacle in preparing additional nurses to meet the growing state demand is the lack of qualified nursing faculty, especially in the area of clinical teaching. The proposed DNP program, by its very nature, is rich in clinical practice and can serve to provide graduates with a strong foundation for clinical teaching in nursing education. The creation of this degree is consistent with the SUS s strategic plan as it will increase access to both graduate and baccalaureate nursing programs allowing the School of Nursing to eventually recruit graduates of the FGCU DNP program for clinical teaching and faculty positions. Nurses prepared at the doctoral level with a blend of clinical, organizational, economic and leadership skills are most likely to be able to critique nursing and other clinical scientific findings and design programs of care delivery that are locally (Florida) acceptable, economically feasible, and which significantly impact health care outcomes (AACN, 2004, p. 3). Implementation of the recent Patient Protection and Affordable Care Act is expected to increase demands on the healthcare workforce, nurse 3

4 practitioner jobs are predicted to grow 94 percent from 128,000 in 2008 to 244,000 in The FGCU DNP Program plans to increase the workforce of nurse practitioners necessary to meet the demand. D. Identify any established or planned educational sites at which the program is expected to be offered and indicate whether it will be offered only at sites other than the main campus. Not applicable Institutional and State Level Accountability II. Need and Demand A. Need: Describe national, state, and/or local data that support the need for more people to be prepared in this program at this level. Reference national, state, and/or local plans or reports that support the need for this program and requests for the proposed program which have emanated from a perceived need by agencies or industries in your service area. Cite any specific need for research and service that the program would fulfill. Currently, there is a great need for advanced practice nurses and graduates are able to choose from multiple employment opportunities. Positions for advanced practice nurses are projected to grow. At any point in time, considering FGCU s five county service area, there are a variety of advanced practice settings including hospitals serving in-patients and out-patients, primary care practices, long term care facilities, private clinics, home health, schools and health departments. Local students who completed our current MSN Nurse Practitioner program have tended to remain in the area following graduation and have begun to meet local workforce needs. However, there continues to be significant unmet need for advanced practice nurses in the communities surrounding FGCU. The School of Nursing is surrounded by counties designated by the Florida Department of Health as having special populations including large numbers of minority or economically challenged individuals and families. These counties also have acute shortages of primary care providers. The School will play a pivotal role in educating and preparing advanced practice nurses to be comprehensive care providers with knowledge and skills necessary to provide fully accountable health care for patients across clinical sites and over time. The proposed DNP program will position the School of Nursing to continue its commitment to this area in providing competent, knowledgeable, and capable health care providers. The FGCU DNP has been designed to meet the national recommendations and guidelines for preparation of advanced practice nurses. The Institute of Medicine (IOM) 2010 report recommended an increase in advanced practice nurses to meet the demand for safe, high quality, and effective services. In fact, the IOM advocates for advances in the education of nurses across all levels, improvements in the practice of nursing across the continuum of care, transformation in the utilization of nurses across settings, and leadership at all levels so nurses can be deployed effectively and appropriately as partners in the healthcare team (IOM, 2010 p. xi). Further, the FGCU DNP will promote the development of evidence-based nursing practice. According to AACN (2006), Scholarship and research are the hallmarks of doctoral education which involves the translation of research into practice and dissemination and integration of new knowledge, which are key activities of DNP graduates. The scholarship of application expands the realm of knowledge beyond mere discovery and directs it toward humane ends (p.11). 4

5 B. Demand: Describe data that support the assumption that students will enroll in the proposed program. Include descriptions of surveys or other communications with prospective students. On average, Advanced Practice Nursing (APN) programs consistently experience higher numbers of applicants, fill their cohort groups, and enjoy a highly qualified applicant pool. The growth of DNP programs nationwide since it was first offered in 2000 further indicates there is a high demand for this level of education for advanced practice nurses (AACN, March 2010). The transition to the DNP will allow the FGCU Graduate Nursing Program to admit students to the capacity of the program, thereby better meeting the workforce needs of the clinical community. Graduates of APN programs receive multiple employment opportunities. One-hundred percent of FGCU advanced practice graduates are employed once certified. Because of the tremendous employment opportunities for APNs, there is a significant demand for positions in APN programs. This demand is reflected by the increased number of applicants to FGCU s APN programs and the percentage of undergraduate nursing students expressing interest in the APN Program. Nationally, the DNP is mandated by the American Association of Colleges of Nursing (AACN) for all APNs entering certification programs by The Commission on Collegiate Nursing Education (CCNE), the accrediting agency for the School of Nursing, will likely only give continuing accreditation to those programs that have moved to the DNP. The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) has mandated that by 2025 all nurse anesthesia programs will award the doctoral degree for CRNAs entering certification programs as part of the certification process rather than a post-certification degree. Currently, prospective graduate students are looking for the availability of programs that will allow a completion of the DNP after graduation from MSN programs. At present, there are no programs offering the DNP on-site in the five county area served by FGCU. Offering the DNP degree with both the MSN to DNP and the BSN to DNP entry options in 2015 will also put FGCU in a good position meet the educational needs of advanced practice nurses in the local community. The School of Nursing (SON) began planning for the transition to a DNP program in The School Graduate Curriculum, Admission, and Progression Committee (GCA&P) conducted a needs assessment, using focus groups and survey approaches to determine perceptions and possible interest in pursuing an advanced practice doctoral degree (See Appendix B). A DNP survey was mailed or given to 150 employed APNs. Thirty-one surveys were handed in to facilitators and 54 were mailed to the SON. The majority of the APNs who completed the survey were over 40 years of age and Caucasian. Twenty-eight percent had a master s degree and 27% had been a nurse practitioner for greater than 10 years. When asked Are you thinking about entering a DNP Program? 20 (13%) stated yes, 11 (7.3%) said maybe, and 29 (19%) reported a no. This most likely reflects the older age of the majority of APNs at the time of the survey as many were planning for retirement. This survey was repeated with graduate nursing students in September 2013 (n= 33). Sixty-one percent (20 out of 33) indicated they were thinking about entering a DNP. The major reasons given for returning to school or to begin a DNP program were to expand my critical thinking and to grow as a clinician, to gain additional expertise in assessing the evidence for implementing current guidelines in an ever changing healthcare environment, and the most important, to be a part of my own professional development plan. Facilitators (Nursing Student Association members) talking with baccalaureate students found an 5

6 increased interest in BSN students wishing to continue their nursing education. Today, as more students, recent graduates, and currently practicing APNs are aware of and knowledgeable about the DNP degree there has been increased inquiries and interest expressed about the program being delivered at FGCU. This trend was confirmed in communications with the Associate Dean of one of the early DNP programs (personal communication, Dr. Patricia Howard, University of Kentucky, College of Nursing, January 29, 2011). Interestingly, five advanced practice graduates of the FGCU MSN program are currently enrolled in DNP programs. Information was also sought in 2010 from prospective employers of DNP graduates (see Letters of support in Appendix B). All were very enthusiastic and affirmative in regard to hiring the graduates when they completed the DNP program (See Appendix B). Several reported the need for increased comprehension in scope and in-depth preparation for advanced practice...as they believed the DNP would be critical in the ever-changing healthcare environment. The IOM (2012) report projects that with changes due to the Affordable Care Act there will be an increased need for nurse practitioners in primary care. According to the IOM report, for health centers to increase the number of patients served (for medical visits) from 16 million to 30 million, an additional 15,600 to 19,400 primary care providers are estimated to be needed. Using the current skill mix of clinicians, 36 percent of these additional providers from 5,600 to 7,000 would be NPs/CNMs/PAs. In addition, health centers would require another 11,600 to 14,400 RNs. Assuming that 75 percent of the advanced practice clinicians would be NPs or CNMs, an additional 16,000 20,000 RNs would be required to meet this demand (IOM, 2012 p. 355, F-6). Prior to the development of DNP programs, specialization in nursing practice came at the master s degree level. These programs prepared advanced practice nurses with specialization as clinical nurse specialists, nurse practitioners, nurse anesthetists, and nurse midwives. With the increased complexity of health care, the emphasis on quality outcomes in health care, and the explosion in health knowledge, the American Association of Colleges of Nursing (AACN, 2004) and the Institute of Medicine (IOM, 2010) provided recommendations stating the current preparation of nurses at the advanced practice level needed to be transformed. As a result, the American Association of Colleges of Nursing (ANCC, 2010) redefined nursing education for leadership and direct care roles emphasizing the doctoral level of education for the advanced practice role. In 2004, AACN published a position paper advocating development of the DNP as the appropriate level of education for advanced practice nurses. Moving advanced practice nursing education to the doctoral level is consistent with the education of other health care professions that have either historically been at, or have moved, to the doctoral level: medicine, dentistry, physical therapy, and pharmacy. Furthermore, it is in keeping with the guidelines for preparation of advanced practice nurses at the doctoral level (AACN, 2006). C. If substantially similar programs (generally at the four-digit CIP Code or 60 percent similar in core courses), either private or public exist in the state, identify the institution(s) and geographic location(s). Summarize the outcome(s) of communication with such programs with regard to the potential impact on their enrollment and opportunities for possible collaboration (instruction and research). In Appendix B, provide data that support the need for an additional program as well as letters of support, or letters of concern, from the provosts of other state universities with substantially similar programs. The recommendation to move advanced nursing practice to the doctoral level has now been endorsed by majority of the national nursing organizations (AACN, 2010). Nationally, of the 388 6

7 nursing programs offering advanced practice nursing (APN) programs, 217 have opened DNP programs and 97 are in the process of planning a DNP program. Student enrollment has gone from 392 students in 2000, to 5,165 in 2009, and to 9,094 in 2011 (AACN). DNP programs in Florida have experienced similar growth. For academic year (AY) to AY , DNP enrollment in Florida grew 358 percent, which includes an increase of 162 enrolled students (Florida Center for Nursing, 2012). Nationally for , student enrollment in DNP programs increased from 9,094 to 11,575 (AACN, 2013 Fact Sheet). Seven universities in the State University System of Florida (Florida Atlantic University, Florida International University, Florida State University, University of Central Florida, University of Florida, University of North Florida, and the University of South Florida) and four private universities (Barry University, Jacksonville University, Nova Southeastern University and University of Miami) in Florida have opened DNP programs (See Table below). Table: Florida Universities Offering Doctor of Nursing Practice (DNP) Programs University Minimum MSN to DNP Credit Hours BSN to DNP Required Credit Hours FGCU Proposed Yes 39 Yes 82 Barry University Yes 38 Yes 80 FAU Yes 41 Yes 80 FIU Yes 36 No FSU Yes 48 Yes 90 Jacksonville Yes 39 No - University Nova Southeastern Yes 36 No - University UCF Yes 40 Yes 82 UF Yes 48 Yes 93 UM Yes 38 Yes Anesthesia track only 147 UNF Yes 48 Yes 82 USF Yes 52 Yes 82 D. Use Table 1 in Appendix A (A for undergraduate and B for graduate) to categorize projected student headcount (HC) and Full Time Equivalents (FTE) according to primary sources. Generally undergraduate FTE will be calculated as 40 credit hours per year and graduate FTE will be calculated as 32 credit hours per year. Describe the rationale underlying enrollment projections. If, initially, students within the institution are expected to change majors to enroll in the proposed program, describe the shifts from disciplines that will likely occur. The projections for student HC and FTE are conservative (See Table 1-B). These projections assume that in year one the average number of students who entered the FGCU MSN program in academic year 2009/2010 through (n= 8) will enter the BSN to DNP. It is anticipated that two students will enroll full-time in the MSN to DNP and six students will enroll part-time in the MSN to DNP for a total of 8 students in the MSN to DNP. By year five, the number of students enrolled the DNP program is projected to have grown from 16 students to 94 students and these will be a combination of full-time and part-time students. These enrollment projections are comparable to enrollment in programs nationally (AACN, 2010; personal communication, Dr. 7

8 Patricia Howard, University of Kentucky College of Nursing, January 29, 2011). E. Indicate what steps will be taken to achieve a diverse student body in this program. If the proposed program substantially duplicates a program at FAMU or FIU, provide, (in consultation with the affected university), an analysis of how the program might have an impact upon that university s ability to attract students of races different from that which is predominant on their campus in the subject program. The university s Equal Opportunity Officer shall review this section of the proposal and then sign and date in the area below to indicate that the analysis required by this subsection has been reviewed and approved. To ensure the desired outcome for student diversity, recruiting efforts will continue within the initial target population area (FGCU s five-county area: Lee, Collier, Charlotte, Hendry, and Glades) and extend to other geographic regions having larger under-represented populations of prospective students. Outreach approaches may include personal contact with appropriate administrators at historically black colleges and universities (HBCUs) including Florida A&M University (Tallahassee, FL) and Bethune-Cookman College (Daytona Beach, FL), inviting currently enrolled students in the undergraduate level who could transition to the graduate level to consider this degree program; networking with the diverse student population to seek potential enrollees of similar background; contact with professional associations and affinity groups whose membership comprise prospective students that meet the program requirements; and communicating through select mailing lists/list serves that serve the targeted student group(s). FGCU s strong commitment to ensure diversity among faculty and staff will further enhance success in the recruitment, retention, and graduation of all students. Signature of Equal Opportunity Officer Date III. Budget A. Use Table 2 in Appendix A to display projected costs and associated funding sources for Year 1 and Year 5 of program operation. Use Table 3 in Appendix A to show how existing Education & General funds will be shifted to support the new program in Year 1. In narrative form, summarize the contents of both tables, identifying the source of both current and new resources to be devoted to the proposed program. (Data for Year 1 and Year 5 reflect snapshots in time rather than cumulative costs.) If the university intends to operate the program through continuing education on a costrecovery basis or market rate, provide a rationale for doing so and a timeline for seeking Board of Governors approval, if appropriate. The School of Nursing personnel budget for salary and benefits in August 2013 was $1,972, of salary and $463, of benefits for a total of $2,436, The first year of the DNP Program will require ~$269, in salaries and benefits for the equivalent of 2.5 faculty members who will move their teaching from the current MSN to teaching in the DNP Program. Additionally, a Senior Secretary position (~$46, salary & benefits) will be required to support all facets of the program and is being requested from Year 1 of the Program. With allocation of ~$269, in faculty salaries and benefits, plus ~$46, 500 for staff support, the first year DNP E&G funding would be ~$315,500. With a projection of 20 student FTEs during year one the cost per FTE would be $15, The reallocation of Nursing E&G funding would be from the current Master of Science in Nursing (MSN) Nurse Practitioner program to the DNP program. 8

9 As the program grows over a 5-year period, the addition of one new advanced practice certified faculty member who will have 100% of their total effort allocated to the DNP Program will be needed each year from Year 2 through Year 4 of the program and an additional 1.5 faculty in Year 5. The salary for a new faculty member with appropriate credentials would range from $100, to $125, based on rank and benefits estimated at 30% would add another $30, to $37, The projections for student enrollment start with the number enrolled in the current Primary Health Care Nurse Practitioner MSN. Student enrollment growth projections are very conservative. These projections assume that in the first year of the program the average number (N= 8) of students who currently enter the MSN program will enter the BSN to DNP Major. Projected enrollment growth of BSN to DNP students increases from 8 to 54 students by year five. Enrollment projections for the MSN to DNP Major start with a head count of 2 full-time and 6 Part-time students in year one. It also projects that eight such students will continue to enter the MSN to DNP each year with enrollment growing to 40 by year five. Between the BSN to DNP Major and the MSN to DNP Major entry points, there is projected to be 94 enrolled students in the DNP by year five. If these projections are correct, enrollment in some of the core, clinical, and capstone courses would require additional faculty each year to meet teaching and capstone project needs. By year five, up to 90 credits of additional course sections from Year 1 could be needed. This would equal the workload of 4.5 additional faculty members allowing for the faculty-student ratios required for clinical courses. The cost of new faculty members plus the continued annual effort allocated to the DNP program by existing faculty members would result in a cost of ~$988, for faculty salary and benefits in the 5th year of the DNP program and a cost of $8, for each FTE. B. If other programs will be impacted by a reallocation of resources for the proposed program, identify the program and provide a justification for reallocating resources. Specifically address the potential negative impacts that implementation of the proposed program will have on related undergraduate programs (i.e., shift in faculty effort, reallocation of instructional resources, reduced enrollment rates, greater use of adjunct faculty and teaching assistants). Explain what steps will be taken to mitigate any such impacts. Also, discuss the potential positive impacts that the proposed program might have on related undergraduate programs (i.e., increased undergraduate research opportunities, improved quality of instruction associated with cutting-edge research, improved labs and library resources). There are no known negative impacts resulting from the proposed program. Rather, the program will result in benefits for BSN enrollees since it is in keeping with national trends. In addition, the proposed plan for the Doctor of Nursing Practice (DNP) Program will allow for continuation of the current selection of advanced practice majors in the present MSN Program. Students can still acquire certification as Advanced Practice Nurses after completing Primary Care Nurse Practitioner studies with either a FNP or Adult Gerontology focus. The curricular plan also provides for a MSN to DNP Major entry for nurses already holding a Master s degree in Nursing. This provides opportunities for advanced studies in the FGCU service area and meets local health needs. The proposed DNP program will also increase undergraduate clinical opportunities and improve quality of instruction as a result of having increased doctorally prepared faculty. The DNP clinical hours in the MSN to DNP Major can be staffed at a 1:12 faculty to student 9

10 ratio. The accrediting agency, CCNE requires a 1:6 faculty-to-student ratio for clinical courses for APN students; however, with certified/licensed APNs there will not be a requirement for onsite supervision/evaluation of practice. As a result, the six to nine clinical credits can be staffed at a higher faculty to student ratio then in the BSN to DNP Major. To encourage adequate enrollment in the MSN to DNP Major, classes will be offered in time frames working professionals want and through low residency/blended formats. C. Describe other potential impacts on related programs or departments (e.g., increased need for general education or common prerequisite courses, or increased need for required or elective courses outside of the proposed major). Does not pertain to proposal. D. Describe what steps have been taken to obtain information regarding resources (financial and in-kind) available outside the institution (businesses, industrial organizations, governmental entities, etc.). Describe the external resources that appear to be available to support the proposed program. Does not pertain to proposal. IV. Projected Benefit of the Program to the University, Local Community, and State Use information from Tables 1 and 2 in Appendix A, and the supporting narrative for Need and Demand to prepare a concise statement that describes the projected benefit to the university, local community, and the state if the program is implemented. The projected benefits can be both quantitative and qualitative in nature, but there needs to be a clear distinction made between the two in the narrative. Currently, there are rapidly changing demands in the national healthcare arena. The continual effort to strive for scientific knowledge through evidence-based medicine and nursing is at the forefront of this movement. The DNP program at FGCU will benefit the University by providing expert nurses, who will act as leaders who will help meet the demands of the Florida nursing shortage and the unmet needs of the population in the five county FGCU service area. The development of the DNP at FGCU will also provide access to higher level prepared faculty, both clinical and academic, which will help address the shortage of doctorally prepared nursing faculty. Moreover, the DNP program will continue to support the University s mission to produce educational leaders by preparing them to be competent healthcare professionals. The program will provide expert practitioners who can meet the demands of the patient in the community. As patient care becomes more and more complex, FGCU will fulfill the need to provide quality assurance along with enhanced patient safety. There have been monumental strides made in nursing research with a focus on clinical problems. This has contributed to the formation of doctoral programs that aim to prepare evidence-based nurse researchers who will directly strengthen clinical and community based care. The development of the DNP program will provide an avenue for student progression from the traditional MSN to the DNP. V. Access and Articulation Bachelor s Degrees Only A. If the total number of credit hours to earn a degree exceeds 120, provide a justification for an exception to the policy of a 120 maximum and submit a separate request to the Board of Governors for an exception along with notification of the program s approval. (See criteria in Board of Governors Regulation 6C-8.014) Does not pertain to proposal. 10

11 B. List program prerequisites and provide assurance that they are the same as the approved common prerequisites for other such degree programs within the SUS (see the Common Prerequisite Manual at FACTS.org). The courses in the Common Prerequisite Counseling Manual are intended to be those that are required of both native and transfer students prior to entrance to the major program, not simply lower-level courses that are required prior to graduation. The common prerequisites and substitute courses are mandatory for all institution programs listed, and must be approved by the Articulation Coordinating Committee (ACC). This requirement includes those programs designated as limited access. If the proposed prerequisites are not listed in the Manual, provide a rationale for a request for exception to the policy of common prerequisites. NOTE: Typically, all lower-division courses required for admission into the major will be considered prerequisites. The curriculum can require lower-division courses that are not prerequisites for admission into the major, as long as those courses are built into the curriculum for the upper-level 60 credit hours. If there are already common prerequisites for other degree programs with the same proposed CIP, every effort must be made to utilize the previously approved prerequisites instead of recommending an additional track of prerequisites for that CIP. Additional tracks may not be approved by the ACC, thereby holding up the full approval of the degree program. Programs will not be entered into the State University System Inventory until any exceptions to the approved common prerequisites are approved by the ACC. Does not pertain to proposal. C. If the university intends to seek formal Limited Access status for the proposed program, provide a rationale that includes an analysis of diversity issues with respect to such a designation. Explain how the university will ensure that community college transfer students are not disadvantaged by the Limited Access status. NOTE: The policy and criteria for Limited Access are identified in Board of Governors Regulation 6C Submit the Limited Access Program Request form along with this document. Does not pertain to proposal. D. If the proposed program is an AS-to-BS capstone, ensure that it adheres to the guidelines approved by the Articulation Coordinating Committee for such programs, as set forth in Rule 6A (see Statewide Articulation Manual at FACTS.org). List the prerequisites, if any, including the specific AS degrees which may transfer into the program. Institutional Readiness Does not pertain to proposal. VI. Related Institutional Mission and Strength A. Describe how the goals of the proposed program relate to the institutional mission statement as contained in the SUS Strategic Plan and the University Strategic Plan. The proposed transition of the current Master of Science in Nursing Degree Program to the Doctor of Nursing Practice (DNP) Program is congruent with the State University System (SUS) of Florida s Strategic Plan for ( StrategicPlan_05-13.pdf) and the revised Florida Gulf Coast University (FGCU) Strategic Plan for (June, 2010). In the strategic plan, the SUS has identified major goals focused on increasing access, meeting workforce needs, building academic excellence of programs and research capacity, and meeting community needs and unique institutional responsibilities (SUS 11

12 Strategic Plan, p. 2). The SUS Plan has seven accountability measures associated with the goals. The proposed DNP program addresses three of the measures: Measurement II increasing degrees conferred at the graduate level Measurement III aimed at increasing the workforce within the health professions and high demand areas Measurement V licensure passage rates in critical areas FGCU s proposed DNP program will increase the number of degrees granted at the graduate level as the majority of graduates from the current FGCU Master of Science in Nursing (MSN) program have stayed in the geographical region and are currently looking at options to earn a Doctor of Nursing Practice Degree. The proposed DNP program will serve as a driving force for the improvement of the health care delivery system by preparing highly qualified nurse experts with competencies in advanced practice nursing. The SUS has designated several disciplines as critical to the service and infrastructure needs within Florida. One such discipline is nursing. The current national shortage of nurses presents challenges to Florida s institutions as they work to prepare qualified individuals to meet current and projected nurse shortages. One pivotal obstacle in preparing additional nurses to meet the growing state demand is the lack of qualified nursing faculty, especially in the area of clinical teaching. The proposed DNP program, by its very nature, is rich in clinical practice and can serve to provide graduates with a strong foundation for clinical teaching in nursing education. The creation of this degree is consistent with the SUS s strategic plan as it will increase access to both graduate and baccalaureate nursing programs allowing the School of Nursing to eventually recruit graduates of the FGCU DNP program for clinical teaching positions. Lastly, the proposed DNP program addresses the licensure/certification passage rates on national certification examinations by modifying and building on the success in its current master s level curriculum. All three measurement areas are in accordance with the goals of Florida s SUS Strategic Plan and the mission of FGCU. The proposed transition of the current FGCU School of Nursing MSN program to a DNP program, positions FGCU to provide advanced practice nursing education that is relevant to the changes occurring throughout the country. Additionally, FGCU will continue to prepare competent advanced nurse clinicians required to meet the healthcare needs of Southwest Florida. Advanced practice nurses with DNP degrees will be uniquely prepared with a strong science foundation upon which to lead the implementation of research-based improvements in the quality of health care in Southwest Florida. B. Describe how the proposed program specifically relates to existing institutional strengths, such as programs of emphasis, other academic programs, and/or institutes and centers. Currently there are no on-site DNP programs in Southwest Florida. The proposed DNP program will allow FGCU to move its advanced practice nursing program to an entry level DNP program in accordance with the AACN proposed deadline. The need for this change is supported by many studies including the 1999 landmark study by the Institute of Medicine (IOM) on medication errors, To Err is human: Building a safer health care system. The DNP curriculum will offer an education that will teach APNs to design, evaluate, and continually improve the health care delivery system. The Doctor of Nursing Practice degree is designed to be a terminal degree for nurses seeking advanced practice. The American Association of Colleges of Nursing (AACN) has proposed that 12

13 the current level of preparation necessary for advanced nursing practice be moved from the master's degree to the doctorate level by the year The Institute of Medicine's 2003 report on health professions education recommended strategies for restructuring all clinical education in the health professions to be consistent with the principles of 21st century health systems. These recommendations stressed that health science students and all working professionals develop and maintain proficiency in five core areas: delivering patient-centered care, working as part of interdisciplinary teams, practicing evidence-based medicine, focusing on quality improvement, and using information technology. In addition, the IOM (2010) report on The Future of Nursing recommends doubling the number of nurses with doctoral degrees by The College of Health Professions and Social Work has one professional practice doctoral degree program, the Doctor of Physical Therapy (DPT). The proposed DNP at Florida Gulf Coast University will be a major step towards bringing the School of Nursing in line with the AACN recommendation that the current level of preparation necessary for advanced practice nursing be moved from the master's degree to the doctorate level. In addition, the development and implementation of the proposed DNP is in line with the University mission to increase the number of degrees and create programs of quality and excellence. The strength of FGCU s advanced practice graduates, as evidenced by their high certification success rates, will be further enhanced with the implementation of the proposed DNP program. Additionally, the proposed DNP program lays the foundation for on-going improvements in the BSN program, by offering opportunities for undergraduate students to continue their education and to become involved in evidence-based research. The integration of doctoral level practice oriented research into clinical practice will allow for the implementation of research-based improvements in the quality of health care delivery in Southwest Florida. Lastly, the proposed DNP program will further enhance the School of Nursing s collaborative efforts with the other programs within the College of Health Professions and Social Work and other University entities such as Arts and Sciences and Environmental Studies. C. Provide a narrative of the planning process leading up to submission of this proposal. Include a chronology (table) of activities, listing both university personnel directly involved and external individuals who participated in planning. Provide a timetable of events necessary for the implementation of the proposed program. The planning process for the development and approval of the DNP followed appropriate department, college, and university procedures. Informal internal and external reviews occurred in addition to the formal review and approval processes detailed in the table below. Feedback was solicited from the following individuals: the Associate Provost of Planning and Institutional Performance; the Director of Program Development, Curriculum, and Accreditation; and the Associate Vice-President of Curriculum and Instruction, the local nursing community, area nurse leaders, and other institutional colleagues within the State of Florida. Table: FGCU DNP Planning Process Date Participants Planning Activity September 2007 Members, SON Director Beginning dialogue for developing the DNP Program October 2007 SON Director, national deans and directors Meet with national deans & directors to seek input on the DNP November 2007 Members Review of national documents and review of literature re: DNP programs 13

14 January 2008 Members Development of focus groups for service area NPs and CRNAs February/March 2008 March 2008 April 2008 August 2008 October 2008 November 2008 December 2008 January 2009 March 2009 April 2009 May 2009 June/July/August 2009 September 2009 October 2009 Members Members and SON Director Members and SON Director Members and SON Director Members and SON Director Members and SON Director Members and SON Director Members and SON Director Members and SON Director Members and SON Director, Ms. Zulay Ritrosky (CRNA faculty & DNP student at UCF), and Dr. Cathy Duff, Acting Associate Vice President for Curriculum and Academic programs Members and SON Director Members and SON Director Members and SON Director Focus group activity CRNA Director attends national meeting re: DNP program development Review of Focus Group Perspectives on the DNP and beginning development of the DNP Survey for University s service area NPs and CRNAs Survey questions finalized and sent out. Work on the above curricular issues continued Survey results tabulated CRNA Director attends national conference re: DNP program development Survey results reviewed SON Director to national deans and directors meeting to seek DNP input Beginning discussion re: Core courses and integration of AACN DNP Essentials, review of other SUS surrounding states DNP programs Continued discussion on Core Courses Agreement on core courses and Capstone Project clinical hours Identification of DNP program structure re: post baccalaureate vs post masters Examination of barriers and problems that will need to be solved prior to submitting the DNP proposal to the Board of Trustees in fall 2010 and development of timeline Clarification of majors within the proposal DNP program Task Force formed for development of new course syllabi Notice sent to faculty re: interest in working on course development for DNP program Preliminary review of Capstone Project criteria AACN accreditation report received 10 year approval Agreement reached as to semesters the Capstone Project to be developed and implemented SON Director to national deans and directors 14

15 November 2009 January 2010 April 2010 May 2010 Members and SON Director Members and SON Director SON Director met with Dr. Paul Snyder, Associate Provost & Associate Vice President for Planning & Institutional Performance and Dr. Cathy Duff, Acting Associate Vice President for Curriculum and Academic Programs Members & SON Director meeting to seek DNP input Post-baccalaureate and post-masters progression plans reviewed and approved Syllabus Task Force report provided and new assignments given Plans formulated re: FGCU key individuals for review of Approval to Plan document Proposed DNP curriculum reviewed with Dr. Peg Gray-Vickrey, Acting Dean, CHP and SON Director Progression Plans with Course sequencing finalized and approved June 2010 September- December 2010 December 2010 February 2011 March 2011 September 2011 SON Director met with Dr. Paul Snyder, Associate Provost and Associate Vice President for Planning & Institutional Performance Members, interested faculty and SON Director Members & SON Director SON Director Contacts External Consultant External Consultant, Dr. Patricia Howard SON Director meets with Dr. Cathy Duff, Office of Curriculum & Instruction Members Approval to Plan signed by Provost DNP proposal drafted External Consultant Sent proposal for Review External Review Returned Areas of proposal requiring refinement identified DNP Community Advisory Group Individuals Identified Consults with Community Individuals October- December 2011 Members March 2012 SON Director Consultation with Deans/Directors Florida Association Colleges of Nursing re DNP developments April 2012 September 2012 Members, SON Director Members, and SON Director met with Dr. Cathy Duff, Interim Associate Provost and Associate Vice President Office of Curriculum & Instruction Review of Florida SUS and Private DNP Programs Revised time-line and process for approval discussed September Members, interested Faculty and SON Revision of DNP proposal December 2012 Director November 2012 SON Director Submitted New Academic Degree Program authorization Pre-proposal form January 2013 Members & SON Director Developed a plan with work assignments towards the DNP proposal February 2013 Members & SON Director Continue to discuss DNP program credit hours March 2013 Members & SON Director Decided on credit hours and the semesters for full-time DNP plan of study 15

16 April 2013 May 2013 June 2013 September 2013 October 2013 Members & SON Director Members & SON Director Members Members & SON Director SON Faculty Organization Members Reviewed by CHPSW Curriculum Committee Full-time DNP curriculum drafted Part-time DNP curriculum drafted DNP course syllabi reviewed Reviewed and revised plan of study Approved DNP Program to move forward Approved DNP Program to move forward Table: Timetable Planning Process Date Request for Approval to Plan Document written May 2010 Reviewed and approved by School of Nursing May 2010 Reviewed and approved by College of Health Professions Dean June 2010 Approval signature by Provost June 2010 Doctor of Nursing Practice program proposal Proposal development initiated May 2009 Proposal reviewed and approved by School of Nursing September 2013 Proposal submitted to the College of Health Professions and Social Work October 2013 (CHPSW) Curriculum Committee Proposal submitted to the University-level February 2014 (GCT) for review Proposal submitted to the University Board of Trustees June 2014 Proposal submitted to the Board of Governors June 2014 Doctor of Nursing Practice Implemented Fall 2015 VII. Program Quality Indicators - Reviews and Accreditation Identify program reviews, accreditation visits, or internal reviews for any university degree programs related to the proposed program, especially any within the same academic unit. List all recommendations and summarize the institution's progress in implementing the recommendations. The Commission on Collegiate Nursing Education (CCNE) is the accrediting body for the School of Nursing (SON). The SON completed its most recent CCNE Self-Study in February, 2009 and is writing a Mid Review for submission in The baccalaureate and master s degree nursing programs at FGCU are fully accredited by the CCNE through The Nurse Anesthesia Program is accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) through In addition, a mandated Seven-Year Program Review by the Florida Board of Governors was completed shortly following the CCNE Self Study. This review was submitted in The SON Self Study and seven year review documents were reviewed at several University levels: College of Health Professions Dean, the Provost and Vice-President of Academic Affairs, the Associate Provost in the Office of Planning and Institutional Performance, and the Associate Vice-President of Curriculum and Instruction. CCNE is approved by the U.S. Department of Education to accredit professional doctoral education programs in nursing. The standards for quality for DNP programs are identified in the Essentials of 16

17 Doctoral Education for Advanced Practice Nursing (AACN, 2006). The DNP Essentials document identifies proposed DNP courses in which content, learning experiences, and evaluation is provided to address each of the eight essentials. Additionally, the DNP capstone project is a terminal scholarly work that represents the culmination of the DNP curriculum and the synthesis of the eight essentials. The combination of course work and the capstone project will allow DNP students the opportunity to demonstrate achievement of the eight essentials and provide full accountability and skill in the translation and evaluation of research for practice and interdisciplinary collaboration. VIII. Curriculum A. Describe the specific expected student learning outcomes associated with the proposed program. If a bachelor s degree program, include a web link to the Academic Learning Compact or include the document itself as an appendix. The Doctor of Nursing Practice (DNP) program at Florida Gulf Coast University is designed to prepare expert nurses to improve health care outcomes and to assume leadership positions in a variety of healthcare settings and educational organizations. The curriculum focuses on providing nurses with the solid science foundation needed to enhance critical reasoning and judgment in the management of complex healthcare situations. Core and specialty courses provide knowledge, skills, and attributes essential for fully accountable practice in today s healthcare environment. Emphasis is on innovative and evidence-based nursing practice to meet the demands associated with increasing complexity in the health care system, improving the safety and quality of patient care delivery, influencing health care policy and the administration of nursing. Learning outcomes for the DNP program are the same for students entering as post master s students or post-baccalaureate students. Learning outcomes for students enrolled in the proposed program reflect the Essentials of Doctoral Education for Advanced Nursing practice (AACN, 2006). Doctor of Nursing Practice Student Learning Outcomes Graduates will: 1. Collaborate with other healthcare professionals to provide high quality, ethical patient- centered care that meets current standards of best practice. 2. Serve as leaders in inter-professional teams to develop quality improvement programs, practice models and guidelines, and impact management of complex health care systems. 3. Integrate advanced critical reasoning and judgment in the management of complex clinical situations and systems in a selected area of advanced practice nursing. 4. Design, implement, and evaluate complex clinical practice strategies based on theoretical, scientific, and ethical knowledge. 5. Implement health care delivery models and strategies designed for increased safety and quality improvement in patient care. 6. Analyze multiple sources of evidence-based research and conduct evaluations of 17

18 clinical outcome data through the use of information technology to identify and evaluate clinical interventions. 7. Employ an evidence-based framework when conducting research to evaluate and develop strategies and interventions to improve health status, access patterns, and identify gaps in care of patients, populations, and organizations. 8. Serve as an advocate for change in health care practice through policy development, implementation, and evaluation. B. Describe the admission standards and graduation requirements for the program. (Please see Appendix C: Catalog Copy) Admission and graduation requirements for the proposed DNP program are congruent with other FGCU graduate level programs. In addition, the School of Nursing admission requirements include: MSN to DNP Major Application Requirements: 1. Application through the Office of Research and Graduate Studies. 2. Official transcript(s) for all colleges and universities attended including a master s degree transcript from a CCNE or Accredited Commission for Education in Nursing (ACEN) accredited nursing program and a regionally accredited institution with a cumulative grade point average (GPA) of 3.0 or higher on a 4.0 scale. 3. Evidence of an unrestricted license or eligibility for licensure as an RN or ARNP in Florida, depending on area of study. 4. A current resume or curriculum vitae. 5. Personal statement of professional goals in 350 words. 6. If applicable, applicants who have attended but not completed another DNP or doctoral nursing program must provide an official transcript from that program and a letter of standing from the dean of the school of nursing (or designee) that also addresses potential for success in a DNP program. 7. Official transcript(s) of completed course work in the applicant s prior MSN program must demonstrate equivalency to the didactic and clinical practice hours of the pre-certification phase of the FGCU BSN to DNP. If not equivalent, this course work must be completed prior to starting the core course work in the MSN to DNP. 8. Provide three professional references that indicate your potential for doctoral study, clinical proficiency, and academic competence using the FGCU recommendation form. 9. A personal interview may be required with designated faculty. MSN to DNP Major Prerequisites: Completion of the following Master of Science in Nursing level courses with a B or better: Pathophysiology, Pharmacology, Physical Assessment, and Research. Graduation requirements for the MSN to DNP include: 1. Successful completion of a minimum of 39 credit hours of doctoral level course work. 2. Cumulative GPA of 3.0 or greater in the DNP program. 18

19 3. Completion of all courses with a grade of B or higher, or satisfactory where applicable. 4. Completion of clinical practice residency requirements. 5. Completion of capstone requirements. BSN to DNP Major Application Requirements: 1. Application through the Office of Research and Graduate Admissions. 2. Official transcript(s) for all colleges and universities attended including a bachelor s degree transcript from a CCNE or Accredited Commission for Education in Nursing (ACEN) nursing program and a regionally accredited institution with a cumulative grade point average (GPA) of 3.0 or higher on a 4.0 scale. 3. Evidence of an unrestricted license or eligibility for licensure as an RN in Florida. 4. Current resume or curriculum vitae. 5. Personal statement of professional goals in 350 words. 6. Provide Graduate Record Exam (GRE) scores, taken within the last 5 years that are competitive on quantitative, verbal, and analytical. 7. Provide three professional references that indicate your potential for doctoral study, clinical proficiency, and academic competence using the FGCU recommendation form. 8. A personal interview may be required with designated faculty. BSN to DNP Prerequisite: Undergraduate level statistics and Health Assessment courses with a grade of B or better. Graduation requirements for the BSN to DNP include: 1. Successful completion of a minimum of 84 credit hours of doctoral level course work. 2. Cumulative GPA of 3.0 or greater in the DNP program. 3. Completion of all courses with a grade of B or higher, or satisfactory where applicable. 4. Completion of Nurse Practitioner Certification exam review course 5. Completion of clinical practice residency requirements 6. Completion of capstone requirements C. Describe the curricular framework for the proposed program, including number of credit hours and composition of required core courses, restricted electives, unrestricted electives, thesis requirements, and dissertation requirements. Identify the total numbers of semester credit hours for the degree. Please see Appendix C: Catalog Copy The FGCU MSN to DNP will be available to candidates who have already completed a master s degree in nursing from a nationally accredited nursing program regardless of specialty practice area. The MSN to DNP will include 39 credits of DNP core course work (including 7 credits for clinical practice hours and 5 credit hours for the capstone project). Additionally, students must complete 500 clock hours of clinical practice which is completed in the clinical practice courses. The FGCU BSN to DNP will be available for specialization as a Nurse Practitioner. The total credit hours required for the Nurse Practitioner BSN to DNP major is 84. The Nurse Practitioner 19

20 major will offer 45 credit hours of specialty practice studies leading to eligibility as a certified Family Nurse Practitioner or Adult-Gerontology Primary Care Nurse Practitioner. The BSN to DNP studies also include the 39 credits in the DNP core that focuses utilization of research in the practice setting, quality of care delivery, examination of health care outcomes, leadership in practice, and fundamentals of nurse education. Additionally, students must have 1000 clock hours of clinical practice which is completed in the specialty and clinical practice courses. The DNP has a Capstone Project that students take over four semesters for a total of five credit hours. The project serves as a synthesis of course and program competencies gained throughout the DNP program of study. D. Provide a sequenced course of study for all majors, concentrations, or areas of emphasis within the proposed program. See Progression Plans for the proposed DNP program in Appendix D E. Provide a one- or two-sentence description of each required or elective course. NGR 6002 NGR 6002L NGR 6xxx NGR 6141 NGR 6460 NGR 6461 NGR 6712 NGR 6811 NGR 6872 Health Appraisal & Interpretation (3). Collection and synthesis of client database and differential diagnosis of common client problems. Using critical thinking and a holistic lifespan approach, students interpret, analyze, and document alterations in health. Health Appraisal & Interpretation Practice (1). Practice section of NGR 6002C. Emphasis is placed skills needed to assess health status of individuals across the lifespan. Health Promotion (3). Focuses on theory and evidence-based health promotion practice of individuals, aggregates, communities, and vulnerable populations in a global, multicultural society. Pathophysiology for Advanced Practice Nursing (4). Emphasis is placed on investigation, analysis, and interpretation of pathophysiologic bases of clinical manifestations of selected alterations in health. Focus is on advanced practice nursing implications for health promotion, maintenance, and restoration. Pharmacology I (4). Study of the pharmacokinetic, pharmacodynamic, and clinical use of pharmacotherapeutic agents. Pharmacology II (3). Comprehensive examination and application of pharmacotherapeutics for acute and chronic health conditions throughout the life span. Foundations of Education (3). Exploration of nursing education within a broad context related to history, philosophy and the principles of adult-learning theory. Scholarly Inquiry (3). Examination and evaluation of questions, methods, designs, and frameworks for research and evidence-based practice. Information Management in Nursing (3). Designed to prepare students to critically analyze, develop, implement, and evaluate healthcare information systems/technologies within clinical and academic settings. 20