DNP Handbook 2014-2015

DNP Handbook 2014-2015 The DNP Program Handbook has been compiled as a resource for students and advisors. It is intended to provide annually updated program information as comprehensively as possible in one place. Information herein is based on College of Nursing requirements for the DNP Program. Policies, procedures, and requirements are subject to change and may be superseded by action of the Professional Graduate Nursing Program Committees of the College of Nursing. Please contact us with any questions you may have: Susan Barnason PhD, RN, APRN-CNS, CEN, CCRN, FAHA, FAAN Professor Director, DNP Program University of Nebraska Medical Center, College of Nursing 1230 O Street, Suite 131 Lincoln, NE 68588-0220 (402) 472-7359 - office (402) 472-7345 - FAX sbarnaso@unmc.edu Denise Ott, BA Office Associate University of Nebraska Medical Center, College of Nursing Center for Nursing Studies, Office 50110 985330 Nebraska Medical Center Omaha, NE 68198-5330 (402) 559-2150 - office denise.ott@unmc.edu The mission and vision of the College of Nursing are accomplished though leadership by faculty, staff, and students. The leadership philosophy of the College embraces resiliency, shaping positive change, pro-active thinking, effective partnerships, and risk-taking toward creative possibilities. REVISED: May 2014

TABLE OF CONTENTS MISSION & VALUE STATEMENT... 2 PHILOSOPHY STATEMENT... 2 GOAL & OUTCOMES... 4 REQUIREMENTS FOR DNP PROGRAM... 5 DNP COURSE DESCRIPTIONS... 6 EXEMPLARS: FULL TIME & Part TIME POST MASTERS DNP PROGRAMS OF STUDY... 9 REQUIREMENTS FOR DNP PROGRAM COMPLETION... 11 DNP PROGRAM INTEGRATED SCHOLARLY PORTFOLIO (ISP)... 11 DNP CAPSTONE PROJECT... 12 CAPSTONE PROCESSES AND PROCEDURES... 17 DNP OPTIONS FOR CERTIFICATION... 19 INFORMATION ON CLINICAL INQUIRY... 19 SOCIAL SECURITY & MEDICARE TAX EXEMPTION POLICIES... 20 FOR STUDENT EMPLOYEES... 20 DOCTORAL STUDENT SCHOLARSHIPS... 20 CHECKLIST AND TIMELINE FOR dnp STUDENTS... 22 APPENDIX A: DNP PROGRAM CURRICULUM VITAE FORMAT... 23 APPENDIX B: TITLE PAGE FOR DNP INTEGRATED SCHOLARLY PORTFOLOIO... 24 APPENDIX D: DNP CLINICAL PRACTICUM LOG... 26 APPENDIX E: DNP CAPSTONE PROPOSAL... 27 APPENDIX G: DNP CAPSTONE PROJECT FINAL REPORT FORMAT... 29 APPENDIX H: TITLE PAGE FOR DNP CAPSTONE PROJECT... 30 APPENDIX I: DNP PROGRAM APPROVAL FORM FOR CAPSTONE PROJECT... 31 1

MISSION AND VALUE STATEMENT 1 The mission of the University Of Nebraska Medical Center College Of Nursing is "to improve the health of Nebraska through premier nursing education programs, innovative research, the highest quality patient care, and service to underserved populations." The goals of the College of Nursing reflect the mission statement and are embedded in the College of Nursing vision statement: Deliver state of the art nursing education that blends traditional learning approaches with emerging learning technologies; Offer health care and health systems solutions grounded in leading-edge nursing science; Promote health, reduce the burden of illness, and lessen health disparities in Nebraska and beyond. PHILOSOPHY STATEMENT 2 The philosophy statement of the College of Nursing is consistent with the overall role and mission of the University of Nebraska Medical Center, which emphasizes education, research, patient care and outreach to underserved populations. This philosophy of nursing and nursing education is embedded in a milieu of commitment to quality of work and learning environments, respect for diversity, and an appreciation of scientific inquiry. HUMAN BEINGS Clients, students, faculty, and co-workers are viewed as unique human beings who are intrinsically valued and worthy of respect. Human beings are embedded in a cultural milieu. They have inherent rights and reciprocal responsibilities. Humans are in the process of constantly evolving and have potential for growth. ENVIRONMENT The environment consists of economic, social, cultural, legal, ethical, technological, ecological, and political forces which interact at local, state, regional, national, and global levels. The environment influences health and how health care is organized and implemented. Human beings interact with, influence, modify, and adapt to the environment. Nursing practice, education, and research are affected by and affect the environment. Environmental forces at all geopolitical levels influence the health care system. HEALTH Health is a dynamic, multidimensional process of developing which is influenced by biological factors, individual perceptions, cultural norms, and environmental forces. It is an important part of human experience and quality of life. Health affects and is affected by human need, potential, behavior and choice. The aim of health care is achievement of a fuller measure of health for all members of society. Achievement of this goal requires an integrated approach and partnerships between clients, health care 1 Approved: February 2009 2 Approved: February 2009 2

professionals and the community. This approach includes promoting wellness and positive lifestyle; facilitating coping; preventing disease, dysfunction, and/or injury; and caring for those who are experiencing health problems. All members of society have a right to access health care. NURSING Nursing is a scholarly practice discipline which integrates both art and science in the care of human beings as individuals and aggregates. The goal of nursing is to promote client health using knowledge, clinical judgment, skills, experience, and leadership. Nursing involves an investment of self in the establishment of reciprocal trusting relationships with clients and health team members. Nurses have a responsibility for ethical awareness in the social, political, legal, ecological, and economic arenas to serve as advocates for client health. The body of nursing knowledge is both experientially and scientifically developed and validated through nursing research and practice. NURSING EDUCATION Nursing is practiced in a health care environment characterized by cultural diversity and rapid advances in knowledge and technology that challenge learned rules, values, and beliefs. Nursing education facilitates development of the critical thinking and creative problem solving skills and the personal and professional integrity essential for practicing nurses to continuously learn, question, and refine the knowledge, values, and beliefs that inform their practice. Nursing education fosters multiple ways of knowing in the development of nursing knowledge, including scientific or empirical knowing, ethical knowing, personal knowing, aesthetic knowing, and others. Thus, the educational process includes the interactions that occur between teachers, students, health team members and clients that promote the development in students of clinical reasoning; psychomotor, communication and technology skills; ethical reasoning; advocacy; and personal and professional integrity. Both teachers and students are responsible for actively engaging as partners in learning and for acquiring the attitudes and skills of life-long expert learners. The different knowledge, skills, and experiences of individual students and faculty are acknowledged in developing learning activities. The practice of teaching in nursing is recognized as a scholarly endeavor. Professional nursing education at the baccalaureate level prepares graduates for practice as beginning nurse generalists. Master's education in nursing prepares nurses for advanced practice roles (nurse practitioner, clinical nurse specialist, and health systems nurse specialists). Doctoral education in nursing prepares nurses to assume leadership in the development of nursing knowledge. 3

GOAL AND OUTCOMES 3 GOAL 3 The goal of the Doctor of Nursing Practice (DNP) program is to prepare graduates for the highest level of nursing leadership and practice within organizations and systems, to improve health care delivery and patient outcomes at all levels and for diverse populations, to serve as faculty in nursing education programs, and to translate research findings for clinical practice. PROGRAM OUTCOMES 4 Upon completion of the program, graduates will be able to: 1. Develop and evaluate new practice approaches based on theories and empirical evidence from nursing and other disciplines. 2. Demonstrate organizational and systems leadership for quality improvement/patient safety for health care systems and populations. 3. Design, implement and evaluate processes to improve health practices and outcomes at the institutional, local, state, regional, national, and international health delivery levels. 4. Demonstrate leadership in the selection, use, evaluation, and design of information systems/technology for improvement and transformation of health care. 5. Lead the development, implementation, and evaluation of health policy and its impact on health outcomes at the institutional, local, state, regional, national, and international health care delivery levels. 6. Engage in interprofessional collaboration in complex health care delivery systems. 7. Design, implement, and evaluate care delivery models and strategies to improve population health. 8. Demonstrate advanced levels of accountability and systems thinking to advance and uphold professional nursing values. 9. Demonstrate advanced levels of clinical judgment, systems thinking, and accountability in designing, delivering, and evaluating care in complex situations. 3 Approved by PGNP Curriculum Committee: October 2012 4 Approved by the University of Nebraska Board of Regents: January 28, 2011 4

REQUIREMENTS FOR DNP PROGRAM DNP PROGRAM CURRICULUM--REQUIRED COURSEWORK5 FOR 2014-2015 ACADEMIC YEAR Course Title Semester Taught BIOS 806 Biostatistics Fall, Spring 3 EPI 820 Epidemiology Fall, Spring 3 NRSG 701 Implementing Evidence-Based Practice Fall 3 NRSG 702 Methods for Assessing Clinical Practice Outcomes Fall 3 NRSG 703 NRSG 704 Changing Complex Systems to Improve Health Care Delivery 2 didactic credits, 2 practicum credits [90 practicum hours] Clinical Inquiry Minimum 7 credit hours (315 clinical practicum hours) Spring Ongoing, after completion of prerequisites NRSG 705 Clinical Inquiry: Development of the Capstone Proposal Problem Statement Summer 1 NRSG 706 Clinical Inquiry: Development of the Capstone Proposal Literature Review Fall 1 NRSG 707 Clinical Inquiry: Development of the Capstone Proposal Conceptual Framework and Methods Fall 1 NRSG 709 Health Care Policy Spring 3 NRSG 731 Transformational Leadership Summer 3 NSRG 755 Health Care Economics and Financial Management Fall 3 4 Credit Hours Minimum of 7 DNP COURSES: PRE-REQUISITES AND CO-REQUISITES* Pre-requisites Co-requisites BIOS 806 or approved graduate level statistics course None None EPI 820: Epidemiology None None NRSG 701: Implementing Evidence-Based Practice NRSG 731 Biostatistics NRSG 702: Methods for Assessing Clinical Practice NRSG 701 NRSG 731 Outcomes Biostatistics NRSG 703: Changing Complex Systems to Improve Health Care Delivery NRSG 704: Clinical Inquiry NRSG 731 NSRG 701 NRSG 702 NRSG 755 Biostatistics NRSG 703 or permission of DNP Faculty Advisor and DNP Program Director NRSG 709 EPI 820 None NRSG 705: Clinical Inquiry: Admission to DNP Development of Capstone Proposal Problem Statement Program None NRSG 706: Clinical Inquiry: Development of the Capstone Proposal Literature Review Same as NRSG 701 NRSG 701 NRSG 707: Clinical Inquiry: Development of the Capstone Proposal Conceptual Framework and Methods Same as NRSG 702 NRSG 702 NRSG 709: Health Care Policy NRSG 731 None NRSG 731: Transformational Leadership **May be taken concurrently w/ Biostatistics. None None Pre-or co-requisite for all other DNP courses NRSG 755: Health Care Economics and Financial Management NRSG 731 None *Tables demonstrate Required Course Work and Associated Pre-requisite and Co-requisite requirements. 5

DNP COURSE DESCRIPTIONS BIOS 806: BIOSTATISTICS This course is designed to prepare the graduate student to understand and apply biostatistical methods needed in the design and analysis of biomedical and public health investigations. The major topics to be covered include types of data, descriptive statistics and plots, theoretical distributions, probability, estimation, hypothesis testing, and one-way analysis of variance. A brief introduction to correlation and univariate linear regression will also be given. The course is intended for graduate students and health professionals interested in the design and analysis of biomedical or public health studies. PREREQUISITE COURSES: None CREDIT ALLOCATION: 3 credits, seminar *Biostatics requirement will be waived if DNP student has BIOS 806 or equivalent within 5 years of admission to DNP Program. 5 EPI 820: EPIDEMIOLOGY This course is designed to prepare the graduate student, professional student or fellow to gain knowledge and skills in basic epidemiological concepts and applications. Major topics to be covered include sources of data, study designs, analytical strategies, interpretation of data, disease causality and control of public health problems. PREREQUISITE COURSES: None CREDIT ALLOCATION: 3 credits, seminar NRSG 701: IMPLEMENTING EVIDENCE-BASED PRACTICE This course builds on an understanding of the scholarship of nursing and the concepts of evidence-based practice. It will prepare students to critically evaluate theories, concepts, and methods relevant to the review, analysis, synthesis, and application of scientific evidence to nursing and interprofessional healthcare practice. The ethical, economic, cultural, and political implications of innovations in evidencebased practice will be explored. PREREQUISITE COURSES: NRSG 731. CO- or PRE-REQUISITES: BIOS 806 or equivalent, or permission of instructor CREDIT ALLOCATION: 3 credits, seminar NRSG 702: METHODS FOR ASSESSING CLINICAL PRACTICE OUTCOMES A variety of approaches can be used to evaluate health and practice outcomes. In this course, students will explore the strengths and weaknesses of different methodologies and data when compared to a variety of clinically relevant issues. Examples of methodological approaches include the use of surveys, observations, and/or interviews, and quality improvement processes. Examples of data include the use of secondary data sets and/or epidemiological data and clinical records data bases. The use of different methodologies combined with the cultural, ethical, political, and economic implications for practice will be explored. PREREQUISITE COURSES: NRSG 731. CO- or PRE-REQUISITES: NRSG 701, BIOS 806 or equivalent, or permission of instructor CREDIT ALLOCATION: 3 credits, seminar NRSG 703: CHANGING COMPLEX SYSTEMS TO IMPROVE HEALTH CARE DELIVERY Students will explore strategies to create, sustain, and evaluate change in complex micro-and-macro systems. Students will engage in futuristic visioning and scenario building to address emerging practice and health care problems. Solutions to complex systems issues will be proposed within the context of relevant ethical, political, economic, and cultural factors. Students will use collaborative and interprofessional skills to explore proposed system solutions. PREREQUISITE COURSES: NRSG 731, BIOS 806, NRSG 701,NRSG 702, NRSG 755 CO- or PRE-REQUISITES: NRSG 709, EPI 820 or permission of instructor CREDIT ALLOCATION: 2 credits, seminar 2 credits Practicum (90 practicum hours) 5 Approved: March 2013 6

NRSG 704: CLINICAL INQUIRY (CAPSTONE PROJECT) Students will further their exploration and analysis of their selected client, population, and/or system. Students own evidence-based analysis and data from either clinical practice and/or epidemiological studies will be used to guide the design and development of interventions directed at practice change, system changes, or aggregate health improvements. Analysis of socio-economic, cultural, ethical, and political implications continues. Building on the student s work, practice interventions are refined. Under guidance of their academic advisor, students implement their designated project and evaluate. Plans for or evidence of dissemination occurs. The clinical practicum hours provide students the opportunity to apply knowledge and newly acquired skills to the practice setting. Practice settings will vary depending on students interest and career goals. The primary aim of the practice work is to design, implement, and evaluate change that will improve health outcomes for individuals, families, communities, and/or populations. Overall, the DNP practicum experiences culminate in the Capstone project. PREREQUISITE COURSES: All DNP required courses or permission of DNP Faculty Advisor and DNP Program Director CO-REQUISITES: NRSG 703 CREDIT ALLOCATION: 7 credits (315 practicum hours) 6 NRSG 705: CLINICAL INQUIRY: DEVELOPMENT OF THE CAPSTONE PROPOSAL PROBLEM STATEMENT 7 Through clinical inquiry, students will further their exploration and analysis of their selected client, population, and/or system. Students own evidence-based analysis and data from either clinical practice and/or epidemiological studies will be used to guide the design and development of interventions directed at practice change, system changes, or aggregate health improvements. Analysis of socio-economic, cultural, ethical, and political implications continues. Building on the student s work, practice interventions are refined. Under guidance of their academic advisor, students implement their designated project and evaluate. Plans for or evidence of dissemination occurs. This is the first of 3 clinical courses that provides a foundation for the DNP program clinical inquiry that culminates in the implementation and evaluation of the DNP Capstone project. It extends the content and experiences of the didactic DNP courses. The student will work closely with his/her DNP faculty academic advisor to develop the problem statement section of the DNP capstone proposal. Prerequisites/co-requisites: Admission to the DNP program Credit allocation: 1 credit (clinical) NRSG 706: CLINICAL INQUIRY: DEVELOPMENT OF THE CAPSTONE PROPOSAL LITERATURE REVIEW 7 Through clinical inquiry, students will further their exploration and analysis of their selected client, population, and/or system. Students own evidence-based analysis and data from either clinical practice and/or epidemiological studies will be used to guide the design and development of interventions directed at practice change, system changes, or aggregate health improvements. Analysis of socio-economic, cultural, ethical, and political implications continues. Building on the student s work, practice interventions are refined. Under guidance of their academic advisor, students implement their designated project and evaluate. Plans for or evidence of dissemination occurs. This is the second of 3 clinical courses that provides a foundation for the DNP program clinical inquiry that culminates in the implementation and evaluation of the DNP Capstone project. It extends the content and experiences of the didactic DNP courses. The student will work closely with his/her DNP faculty academic advisor to develop the review of literature section of the DNP capstone proposal. Prerequisites/co-requisites: NRSG 701 Credit allocation: 1 credit (clinical) 6 Approval for change in NRSG 704 prerequisites: March 2014 7 Approval of NRSG 705, NRSG 706 & NRSG 707: July, 2013 7

NRSG 707: CLINICAL INQUIRY: DEVELOPMENT OF THE CAPSTONE PROPOSAL CONCEPTUAL FRAMEWORK AND METHODS 8 Through clinical inquiry, students will further their exploration and analysis of their selected client, population, and/or system. Students own evidence-based analysis and data from either clinical practice and/or epidemiological studies will be used to guide the design and development of interventions directed at practice change, system changes, or aggregate health improvements. Analysis of socio-economic, cultural, ethical, and political implications continues. Building on the student s work, practice interventions are refined. Under guidance of their academic advisor, students implement their designated project and evaluate. Plans for or evidence of dissemination occurs. This is the third of 3 clinical courses that provides a foundation for the DNP program clinical inquiry that culminates in the implementation and evaluation of the DNP Capstone project. It extends the content and experiences of the didactic DNP courses. The student will work closely with his/her DNP faculty academic advisor to develop the conceptual framework and methods sections of the DNP capstone proposal. Prerequisites/co-requisites: NRSG 702 Credit allocation: 1 credit (clinical) NRSG 709: HEALTH CARE POLICY This course introduces students to health policy in the US government system and to the role of research in shaping health policy. Students will critically appraise a policy relevant to an area of research or practice and plan implementation strategies for policy change at the appropriate level of government. Students will develop verbal and written communication skills for effective translation of research and policy implications to lay and professional audiences. PREREQUISITE COURSES: NRSG 731 or permission of instructor CREDIT ALLOCATION: 3 credits, seminar NRSG 731: TRANSFORMATIONAL LEADERSHIP This doctoral seminar introduces the PhD and DNP student to the concepts and principles of transformational leadership within the context of health care. Using complexity science as a theoretical foundation, the course challenges students to create new ideas, adopt new behaviors and explore new vulnerabilities from which to view and solve health care dilemmas. Transformational leaders are challenged to implement and sustain organizational and systems change to support the healing and caring that leads to improved health outcomes. The three major constructs of transformational leadership (self-transformation, patient centered transformation, health systems transformation) will be explored related to health outcomes. PREREQUISITE COURSES: None CREDIT ALLOCATION: 3 credits, seminar NRSG 755: HEALTH CARE ECONOMICS AND FINANCIAL MANAGEMENT Examination of health care economic trends, reimbursement issues, funding sources, and related ethical issues. Application of key principles and methods of financial analysis, cost analysis, budgeting, and business and grant planning. PREREQUISITE COURSES: NRSG 731 or permission of instructor CREDIT ALLOCATION: 3 credits, seminar 8 Approval of NRSG 705, NRSG 706 & NRSG 707: July 2013 8

EXEMPLARS: FULL TIME AND PART TIME POST MASTERS DNP PROGRAMS OF STUDY DNP Program: Full Time (FT) Plan of Study for POST MASTERS Students* Course # Title Credits Summer 2014 (Year 1) BIOS 806 Biostatistics/or alternate approved graduate statistics course 3 NRSG 705 Clinical Inquiry: Development of the Capstone Proposal Problem Statement 1 NRSG 731 Transformational Leadership 3 Fall 2014 NRSG 701 Implementing Evidence-Based Practice 3 NRSG 702 Methods for Assessing Clinical Practice Outcomes 3 NRSG 706 Clinical Inquiry: Development of the Capstone Proposal Literature Review 1 NRSG 707 Clinical Inquiry: Development of the Capstone Proposal Conceptual Framework and Methods NRSG 755 Health Care Economics and Financial Management 3 Spring 2015 EPI 820 Epidemiology 3 NRSG 703 Changing Complex Systems to Improve Health Care Delivery (2 didactic/ 2 Clinical (DNP Practicum) credits) NRSG 709 Health Care Policy 3 Summer 2015 (Year 2) NRSG 704 Clinical Inquiry 4 Fall 2015 NRSG 704 Clinical Inquiry 3 TOTAL 35 *This table illustrates an approach for full-time plan of study. 1 4 9

DNP Program: PART-TIME (PT) Plan of Study for POST MASTERS Students Course # Title Credits Summer 2014 (Year 1) NRSG 705 Clinical Inquiry: Development of the Capstone Proposal Problem Statement 1 NRSG 731 Transformational Leadership 3 Fall 2014 BIOS 806 Biostatistics/or alternate approved graduate statistics course 3 NRSG 701 Implementing Evidence-Based Practice 3 NRSG 706 Clinical Inquiry: Development of the Capstone Proposal Literature Review 1 Spring 2015 EPI 820 Epidemiology 3 NRSG 709 Health Care Policy 3 Fall 2015 (Year 2) NRSG 702 Methods for Assessing Clinical Practice Outcomes 3 NRSG 707 Clinical Inquiry: Development of the Capstone Proposal Conceptual Framework and Methods NRSG 755 Health Care Economics and Financial Management 3 1 Spring 2016 NRSG 703 Fall 2016 (Year 3) Changing Complex Systems to Improve Health Care Delivery (2 didactic/ 2 Clinical (DNP Practicum) credits) 4 NRSG 704 Clinical Inquiry 4 Spring 2017 NRSG 704 Clinical Inquiry 3 TOTAL 35 *This table illustrates an approach for part-time plan of study. Other approaches are possible, as determined by the student and advisor. 10

REQUIREMENTS FOR DNP PROGRAM COMPLETION At the completion of the DNP program, students are recognized for 1. Submission of a DNP Integrated Scholarly Portfolio. 2. Completion of DNP Capstone Project. DNP PROGRAM INTEGRATED SCHOLARLY PORTFOLIO (ISP) 9 1. At the completion of the DNP program, students are recognized for their achievements in a selected area of expertise as documented in the DNP Integrated Scholarly Portfolio. This expertise is evident in their ability to complete a capstone project, communicate information to a variety of audiences and provide service through their professional and community endeavors and to demonstrate competency in all domains of DNP practice. 2. The DNP Integrated Scholarly Portfolio includes: a. DNP Curriculum vitae (refer to Appendix A: DNP Curriculum Vitae format) b. DNP Clinical Practicum Log c. Final DNP Capstone Project Report d. Service to the Profession e. Attendance at professional/research meetings/conferences f. Evidence of paper or poster presentation at professional/scientific conference g. Exemplars representing scholarly work in DNP courses: DNP Course Critical Course Assignment Completed NRSG 731: Transformational Leadership Transformational Leadership paper NRSG 755: Business Plan and Practice Initiative Health Care Economics and Financial Project Management NRSG 701: Implementing Evidence-Based Evidence Tables Practice Systematic review of the literature NRSG 702: Methods for Assessing Clinical Practice Microsystem plan Outcomes NRSG 703: Changing Complex Systems to Improve Health Care Delivery System Change Clinical Project NRSG 709: Health Care Policy Policy Analysis paper Influencing health practices/policy paper 3. The DNP Integrated Scholarly Portfolio will be updated annually by January 31 st and submitted electronically to the DNP Academic Advisor and DNP Program Director. Refer to Appendix B: Title Page of DNP Scholarly Portfolio and Appendix C: DNP Program Approval Form for Final Integrated Scholarly Portfolio. 9 Updates Approved: May 2013 11

DNP CAPSTONE PROJECT DNP CLINICAL PRACTICUM REQUIREMENTS Students must complete a minimum of 1000 post-baccalaureate practice hours. For post-master s students, practice hours from the student s MSN program will be evaluated and credit will be awarded for verified practice hours. Students will further their exploration and analysis of their selected client, population, and/or system. Students own evidence-based analysis and data from either clinical practice and/or epidemiological studies will be used to guide the design and development of interventions directed at practice change, system changes, or aggregate health improvements. Analysis of socio-economic, cultural, ethical, and political implications continues. Building on the student s work, practice interventions are refined. Under guidance of their academic advisor, students implement their designated project and evaluate. Plans for or evidence of dissemination occurs. The clinical practicum hours provide students the opportunity to apply knowledge and newly acquired skills to the practice setting. Practice settings will vary depending on students interest and career goals. The primary aim of the practice work is to design, implement, and evaluate change that will improve health outcomes for individuals, families, communities, and/or populations. Overall, the DNP practicum experiences culminate in the Capstone project. Objectives: 1. Design, implement, and evaluate new practice approaches or health practices to meet the current and/or future needs of patient populations at the institutional, local, state, national, regional, and/or international health delivery levels. 2. Actively engage in leadership to develop and evaluate health policy. 3. Effectively communicate and collaborate with a variety of professionals to create and implement change in complex healthcare delivery systems. 4. Design, direct, and evaluate quality improvement methodologies to promote safe, timely, effective, efficient, equitable, and patient-centered care. 5. Disseminate findings from evidenced-based practice and research to improve healthcare outcomes. A minimum of 540 clinical practicum hours are for DNP post-masters students. DNP clinical practicum hours are taken in the following courses: NRSG 703: Changing Complex Systems to Improve Health Care Delivery, 2 credits (90 hours) NRSG 704: Clinical Inquiry: Minimum of 7 credits (315 hours) NRSG 705: Clinical Inquiry: Development of the Capstone Proposal Problem Statement, 1 credit (45 hours) NRSG 706: Clinical Inquiry: Development of the Capstone Proposal Literature Review, 1 credit (45 hours) NRSG 707: Clinical Inquiry: Development of the Capstone Proposal Conceptual Framework and Methods, 1 credit (45 hours) The course NRSG 703 Changing Complex Systems to Improve Health Care Delivery includes a 2 credit hour practicum or 90 hours of clinical practicum. In this practicum students will select a micro or macro system and/or aggregate population of interest. Students will use newly learned system theories and models to evaluate their selected practice of interest. Students will begin to explore and integrate principles of finance, economics, health policy, ethics, and cultural diversity to develop and implement plans for practice-level and/or system-wide quality improvement. Students will employ interprofessional communication and collaborative skills in the design and evaluation of their quality improvement plans. Students will evaluate the intersection of the micro level with health care delivery system. Ethical implications of change will be analyzed. 12

The DNP clinical practicum experiences culminate in the Capstone Project (described below) conducted in the course NRSG 704 Clinical Inquiry. NRSG 704 includes a minimum of 315 clinical practicum hours. In addition, NRSG 705, NRSG 706 and NRSG 707 are clinical practicums with 45 hours per course respectively. Additional hours may be needed to fulfill the DNP requirement of 1000 post-baccalaureate practice hours. DETERMINATION OF DNP CLINICAL PRACTICUM HOURS 1. Qualified APRN post-masters DNP students (nurse practitioner, clinical nurse specialist, certified nurse anesthetist, and midwife) with certification in their area of specialty are recognized as having a minimum of 500 hours clinical hours in their master s program. These students will be required to complete a minimum of 500 DNP clinical practicum hours in their program of study. a. DNP Post-masters students who do not have certification as APRN, but have graduated from a master s program that prepared them as an APRN and were qualified at graduation to certify as an APRN, will be recognized as equivalent to having 500 clinical hours in their master s program. These students will be required to complete a minimum of 500 DNP practicum hours in their program of study. 2. Qualified post-masters students with a master of science in nursing leadership/administration will be evaluated based upon the total number of clinical hours in their master s program. a. Post-masters students who have certification as an Advanced Nurse Executive (NEA- BC), a Nurse Executive (NE-BC or CENP), or as a Certified Nurse Manager and Leader (CNML) are recognized as having a minimum of 500 hours clinical hours. These students will be required to complete a minimum of 500 DNP practicum hours in their program of study. 3. Post-master s students who do not have advanced certification (APRN-NP, APRN-CNS, APRN- CRNA, APRN-CNM, NEA-BC, NE-BC or CENP, CNML) will be required to submit a professional portfolio that documents clinical activities and scholarship to meet the criteria for clinical hours for the DNP program. The portfolio should include a resume or curriculum vitae, and a description of the individual s practice experience; academic and specialized programs of study in their specialty area (including the number of clinical hours and type of clinical experiences). a. Students who do not meet the clinical hours through submission of a professional portfolio will be evaluated and required to take DNP clinical residency hours in addition to DNP clinical practicum hours in their plan of study to provide an individualized clinical plan based on their background, experience and learning needs to complete the required 1,000 clinical hours for the DNP degree. In such cases, 45 clinical hours are the equivalent of 1 semester credit hour. b. DNP clinical residency hours will be in the student s area of specialization and supervised by DNP program academic advisor. 1) NRSG 689: Special Topics in Graduate Nursing Clinical Practice 13

DNP CLINICAL PRACTICUM EXPERIENCES The student and their DNP faculty academic advisor will discuss the site for the DNP clinical practicum experiences. The student will be responsible for arranging for a practicum experience within his/her work environment or another relevant practice setting. The DNP faculty academic advisor and student will verify that there is a contractual agreement between UNMC College of Nursing and the practice site selected. A clinical mentor from the practice setting should be identified. It is preferable that this mentor have a graduate degree in a relevant healthcare discipline. The clinical mentor may provide feedback to the DNP faculty academic advisor; however the DNP faculty academic advisor is responsible for grading the DNP clinical practicum (NRSG Courses 704, 705, 706, & 707). DNP Clinical Practicum hours include: 1. Direct care or practice contact hours 2. Practice experiences that are outside of the job description and responsibilities of the student. The practice experience must have goals and learning outcomes completed during a mentored relationship with a clinical expert and/or faculty member In depth work with clinical experts, including an interdisciplinary team Meaningful engagement in the practice environment Programmatic efforts to address a clinical practice issue Mobilizing interdisciplinary teams to solve complex clinical problems Significant meetings that related directly to the outcomes Discussions with preceptor/mentor and others who can add to the outcome Data collection and analysis Organizational assessment of current standard of care and then to facilitate translation of evidence based findings as needed into practice The DNP student will keep a log of the clinical practicum hours. The DNP Clinical Practicum log will include the: a) approved objectives for the clinical practicum experiences, b) types of clinical experiences/clinical learning related activities, c) clinical mentor (if applicable) and d) log of time related to clinical experiences/clinical learning related activities. See Appendix D: DNP Clinical Practicum Log GUIDANCE OF THE CAPSTONE PROJECT 10 1. Guidance of capstone project is provided by individual DNP faculty academic advisor in conjunction with the Professional Graduate Professional Nursing Admission, Progression, Graduation and Scholarship (PGNPA) committee. This committee will oversee all capstone projects to insure appropriate scope and consistency of expectations. Students will not have individual capstone committees. However, they may have a clinical mentor and/or consultant, such as a stakeholder with an interest in a specific project. a. Role of DNP faculty academic advisor/chair Capstone Project will include assuming primary responsibility for guiding the student through completion of the doctoral project, to include guidance with: i. Refinement of the written capstone project proposal ii. Completion of submission of an application to the IRB iii. Implementation of the approved capstone project, including supervision of DNP clinical practicum. 10 Revisions Approved: May 2013 14

b. Role of Capstone Project Clinical Mentor and/or Stakeholder A clinical mentor and/or stakeholder may be included as an expert or consultant on the student s capstone project. The clinical mentor and/or consultant have practice, content or methodology expertise in the student s area of interest and in particular in the student s capstone project focus. STATISTICAL CONSULTATION AVAILABLE FOR DNP STUDENTS 11 Statistical consultation for the DNP capstone project will be available for the DNP student. 1. The DNP student and their DNP Faculty Advisor can make an initial joint appointment meeting for a 30 to 60 minute statistical consultation with a CON biostatistician*. Appointments should be made as students are preparing their DNP capstone proposal, after they have a fairly complete draft from working with their advisor, and PRIOR to submission of the proposal for final approval. The biostatisticians will also be available to answer questions before a draft is completed-to be sure communication is clear, all meetings need to be with students and their advisors. 2. The DNP student will submit the DNP proposal to the biostatistician prior to the meeting. The purpose of the meeting with the DNP student, DNP faculty advisor and the biostatistician would be to: a. Review the purpose, aims, and methods (including design, measurement tools, data collection and planned data analysis) with the biostatistician. b. Discuss proposal as it relates to the plans for data entry. c. Discuss recommendations for data analysis and strategies to conduct the analysis (e.g., using SPSS). d. Discuss the learning needs for the student to manage data collection, data entry, data analysis and interpretation of data analysis. e. Discuss available resources to support the DNP students DNP project analysis (e.g., CON NNRC research website resources). f. Discuss any additional plan for accomplishing the learning needs of the student. *Further consultation with the biostatistician will be available if needed as the project is being carried out. Arrangements for any final analysis assistance need to be made well in advance of graduation: no later than October 15th for December graduation, March 15th for May graduation, and June 15th for August graduation. Students are permitted up to 5 hours of statistical consultation per semester. Please make an initial appointment with Leeza Struwe on the Lincoln campus for either an in person or by phone consultation. Adobe Connect and other methods are also available. Send all documents, data files, etc. at least 3 days in advance of the appointment to Lstruwe@unmc.edu. Please book your appointment time at: http://leezastruwe.youcanbook.me/. If it is a phone consultation include the phone number where you and your DNP faculty advisor can be reached at your selected date and time. 11 Approved: January 2014 15

DNP CAPSTONE PROJECT PROPOSAL APPROVAL 12 1. The student will obtain approval from their DNP faculty academic advisor to submit their DNP capstone project proposal to the DNP program director. After review and approval by the DNP program director, the student s proposal is sent to the Professional Graduate Nursing Program Admission, Progression, Graduation and Scholarship (PGNPA) committee. The specific components of the Capstone project proposal are delineated in Appendix E. 2. Process for DNP Capstone project a. The DNP program director and the Professional Graduate Nursing Program Admission, Progression, Graduation and Scholarship (PGNPA) committee will review the proposed capstone project using the evaluation rubric (DNP Capstone Project Proposal Review Appendix F). 1) In the event that the Professional Graduate Nursing Program Admission, Progression, Graduation and Scholarship (PGNPA) committee has recommendations for revision, the DNP student will confer with his/her DNP faculty academic advisor and make recommended changes/edits as indicated. When the revised DNP Capstone proposal has been approved by the student s faculty academic advisor and DNP program director, a request for final approval by the Professional Graduate Nursing Program Admission, Progression, Graduation and Scholarship committee (PGNPA) will be submitted by the DNP program director. b. Institutional Review of DNP Capstone Proposal c. The student will submit his/her capstone project proposal to the UNMC Institutional Review Board after their proposal has been approved by the Professional Graduate Nursing Program Admission, Progression, Graduation and Scholarship committee (PGNPA). d. The student will also need to seek IRB approval from the practicum agency site. In some cases, practicum agencies will waive further IRB approval if UNMC IRB has approved the proposal. The letters of approval from UNMC IRB and the practicum agency IRB will be included in the final capstone project report. 12 Revisions Approved: Revisions Approved: May 2013 16

CAPSTONE PROCESSES AND PROCEDURES PROGRESSIONS TOWARD THE CAPSTONE PROJECT The DNP faculty academic advisor oversees the student s plan of study, including the capstone project, beginning with the student s acceptance into the DNP program. Planning for the didactic and practicum components of the DNP curriculum takes place concurrently. Specifically, plans for the capstone project begin early in the DNP program and evolve as the student progresses through the didactic course work. The 700-series of DNP courses is designed to build toward the student s capstone project in the following ways: NRSG 701: Students explore the evidence for practice change in their clinical areas, begin to identify a specific focus for their capstone project, and develop the building blocks for the components of the capstone project. NRSG 702: Students begin to design their capstone project and identify methods for assessing and measuring outcomes NRSG 703: Students identify system-level considerations relevant to their capstone projects. This course includes a DNP clinical practicum component (2 credits/ 90 clinical hours), which can be used for preliminary work on the capstone. By the completion of NRSG 703 (or shortly thereafter) students should have their plans for the capstone project well-developed and ready to move through the approval process. By the completion of NRSG 703 (or shortly thereafter) full-time students should have a capstone plan that has been approved by the advisor and DNP program committee, and is ready for submission to the IRB. Part-time students will likely have a more extended time frame for capstone approval, as they may have additional course work to complete after NRSG 703. NRSG 704: Students develop, implement and evaluate their DNP capstone project. NRSG 705: Students, with the guidance and mentorship of their advisor, develop the problem statement section of their DNP capstone project. NRSG 706: Students, with the guidance and mentorship of their advisor, develop the review of literature section of their DNP capstone project. NRSG 707: Students, with the guidance and mentorship of their advisor, develop the conceptual framework and methods sections of their DNP capstone project. NRSG 709: Students explore the policy implications of practice change in their areas. NSRSG 731: Students begin to explore the meaning of innovation, collaboration, and practice change to improve patient outcomes. NRSG 755: Students analyze the cost implications of practice change. 17

SUMMARY OF STEPS RELATED TO THE CAPSTONE PROJECT As students progress through the didactic course work: Advisors meet with students at least once a semester to discuss initial and evolving ideas about the capstone project. Upon completion of the course work: Students prepare a plan (proposal) for the capstone. Upon approved by the advisor: The plan is submitted to the DNP program committee. Upon approval by the PGNPA committee: The plan is submitted to the IRB.. During NRSG 704, Clinical Inquiry and other related clinical inquiry courses (NRSG 705, NRSG 706 and NRSG 707: Students engage in their clinical practicum for their capstone projects. FINAL OUTCOMES OF DNP CAPSTONE PROJECT 13 1. Capstone projects will result in both written and presentation outcome products. These products may take different forms, based on the nature of the capstone and opportunities available to students. The final written DNP capstone project will be submitted to the DNP program prior to graduation. Refer to Appendix G for DNP Capstone Project Final Report Format. Also refer to Appendix H for a DNP capstone project cover page and Appendix I for a DNP Program Approval Form for Capstone Project. 2. The written outcome could include either of the following options: a. A final report, including an executive summary, suitable for dissemination to stakeholders. Stakeholder is defined broadly and could be individuals working at any level in a healthcare system, consumer groups, advocacy organizations, legislative staff, etc. The final report should be in a style that is professional and at the same time readable and engaging for a non-academic audience. The final report and executive summary must be completed and approved prior to final DNP program completion and graduation. i. The executive summary should be considered as a stand alone document that is a concise description of the project accentuating key findings and/or products produced and related implications. This is usually no longer than 1 page. The executive summary provides an overview of the project. Bullet point format is acceptable and should be used to conserve space in the executive summary. The summary should include the key points from the report: a) description of the project, b) review of evidence-based literature, c) results/findings, d) evaluation, and e) outcomes. b. A manuscript suitable for publication in a peer-reviewed journal (preferably a practice journal). The manuscript should be written in the style of the target journal. It must be submitted to the journal prior to final DNP program completion and graduation, but does not need to have been accepted by time of graduation. 3. The presentation outcome could include either of the following options: a. An oral presentation to stakeholders. Again, stakeholder is defined broadly. The presentation to stakeholders must be scheduled prior to graduation, although it may actually take place after the student has graduated. The PowerPoint for the presentation must be completed and approved by the advisor prior to graduation. b. A poster or podium presentation at a professional meeting. The abstract for the poster or podium presentation must be ready for submission prior to graduation. However, depending of the date of the Call for Abstracts, the student s abstract may be submitted after graduation. 13 Revisions Approved: May 2013 18

DNP OPTIONS FOR CERTIFICATION DNP students and graduates are encouraged to complete certification in a relevant content area based on individual career goals and areas of study. DNP graduates who are certified as nurse practitioners, nurse anesthetists or clinical nurse specialists are strongly encouraged to maintain that certification as evidence of clinical knowledge and skill. There are additional options for certification that relate to those DNP students and graduates that have a nursing leadership/administration focus that includes: Advanced Nurse Executive (NEA-BC), a Nurse Executive (NE-BC or CENP), or as a Certified Nurse Manager and Leader (CNML). INFORMATION ON CLINICAL INQUIRY UNMC INSTITUTIONAL REVIEW BOARD All clinical inquiry conducted as a student at UNMC must be approved by the UNMC IRB (even if the data will be collected in the community or another institution). All research proposals (including exempt) must have peer review in the College of Nursing before transmittal to the UNMC IRB office. Peer review is conducted by the CON Research Committee. Contact your advisor regarding specific requirements for IRB proposals. Graduate students should submit their IRB application to the NNRC research office before submitting them to the IRB. Contact the NNRC office for current information. Note. If a doctoral student has an NRSA or other research support where a portion of the monies are paid back to the NNRC for research support, the NNRC will provide full services, similar to what we provide for faculty, for submission of the student's IRB application. On June 5, 2000, the NIH mandated investigator education in the protection of human subjects. This requirement represents a partial response on the part of the Federal government to the serious compliance problems which have arisen at a number of institutions during the last two years. "Beginning on October 1, 2000, the NIH will require education on the protection of human research participants for all investigators submitting NIH applications for grants or proposals for contracts or receiving new or noncompeting awards for research involving human subjects." (NIH Guide, June 9, 2000). The Association of American Universities (AAU) Task Force on Research Accountability which was cochaired by President L. Dennis Smith issued a report on June 28, 2000 which stated that "Universities must ensure that all personnel (faculty, researchers, management, administrative staff) directly involved in human subjects research understand the applicable laws, regulations and ethical standards governing the protection of human subjects. All personnel engaged in the direct conduct of such research should be required to receive appropriate education designed for their level of involvement. Upon completion of training, an examination geared to each person's level of involvement should be administered, resulting in a designation (e.g., credentialing or certification) that the individual may engage in human subjects research." In response to the NIH mandate and the AAU Task Force recommendations UNMC/NHS/UNO will require all key personnel involved in the conduct of human subjects research to be certified by CITI training. Key personnel are considered to be the following: (1) Principal Investigators, (2) Secondary Investigators, (3) Participating Physicians/Health Care Personnel and (4) Research Coordinators. This applies to all faculty, staff and students who fall into any of these categories. Required web-based training program is on-line at www.unmc.edu/irb. The UNMC/NHS/UNO IRB does not approve research proposals unless all key personnel listed in Section 1 of the IRB application are certified. 19