DNP 2015 2016
TABLE OF CONTENTS Accreditation and Educational Outcomes 1 Curriculum of the Post-Master s DNP Program 1-2 Program of Study 2-3 Course Descriptions for Core Courses 4-6 The E-Portfolio 6-7 DNP Scholarship 7 DNP Project Team 8 DNP Advisor 8 DNP Faculty Project Team Member 8 Organizational Mentor 8 Capstone Justification 8-9 Capstone Defense and Oral Examination 9 Capstone Justification and Defense Process 10 1
ACCREDITATION AND EDUCATIONAL OUTCOMES The Doctor of Nursing Practice (DNP) program was approved by the Maryland Higher Education Commission in September 2007. The Board of Commissioners for the Commission of Collegiate Nursing Education (CCNE) granted accreditation to the Johns Hopkins School of Nursing (JHSON) Doctor of Nursing Practice Program (DNP) through 12/31/2018. Building on the master s nursing curricula, students in this post-master s DNP program are prepared at the most advanced level of nursing practice. Graduates of the practice-focused program are prepared to generate new knowledge through innovation of practice change, the translation of evidence, and the implementation of quality improvement processes in specific practice settings, systems, or with specific populations to improve health or health outcomes. New knowledge generated through practice innovation could be of value to other practice settings and is considered transferrable but is not considered generalizable (American Association of Colleges of Nursing, 2015). At the completion of the DNP program, the graduate: 1. Practices at the highest level of nursing by integrating nursing science with ethics and the biophysical, psychosocial, analytical, organizational, and public health sciences 2. Demonstrates organizational and systems leadership for quality and safety in health care systems; 3. Utilizes clinical scholarship and analytical methods for evidence-based practice 4. Applies information systems and technology for the provision and/or transformation of health care 5. Leverages transdisciplinary collaboration for the improvement of individual and population health outcomes 6. Utilizes strategies of risk reduction/illness prevention, health promotion, and health maintenance for individuals and populations 7. Develops, evaluates, advocates and provides leadership for health care policy that shapes health care financing, regulation, access, and delivery CURRICULUM OF THE POST-MASTER S DNP PROGRAM This post-master s Doctor of Nursing Practice (DNP) program builds on existing curriculum currently found in masters nursing programs. The focus is on clinical practice that is innovative and evidence based; translates credible research findings for effective clinical practice; and applies research processes to evaluate outcomes. The DNP program is designed for nurses involved in any advanced practice role, including but not limited to clinical nurse specialist, nurse practitioner, nurse midwife, nurse anesthetist, and public health practitioner, in addition to, nurse executive, nurse informatician, and health care policy analyst. Students are expected to complete a minimum of 1,000 post-baccalaureate practice hours. Up to 500 practice hours spent in the master s nursing program can be counted as post-baccalaureate practice hours, provided they can be verified. Verification of hours can be completed in various ways, including forms sent to the student s master s degree program, transcript review, and documentation of national certification requiring academically supervised practicum hours. The program of study (see Table 1 and Table 2) is offered in an executive style using face-to-face, distance, and online course technologies. The program encompasses 40 credits that can be completed in 6 semesters spanning 24-months of study. The program of study includes 25 credits of required courses (core and analytics), 4 credits of electives, and 11 credits of capstone project/residency that are tailored to each student s area of integrated scholarship. Students are expected to complete degree requirements within 5 years of enrollment. With the exception of elective credits, the program of study is prescriptive. On matriculation in the first semester, DNP students are automatically registered for the core courses. 1
Students in the DNP Program satisfy all academic requirements, adhere to all policies of the JHSON, follow the relevant scope of practice, and comply with the ANA Code of Ethical Conduct for Nurses. Table 1. DNP PROGRAM OF STUDY CLASS OF SPRING 2017 Semester Course # of credits 210.800: Foundation for Scholarship 2 Semester 1 210.896: Capstone I: Mentored Scholarship 3 Semester 2 210.803: Nursing Inquiry for EBP 3 210.801: Analytic Approaches 3 Semester 3 210.805: Translating Evidence To Practice 3 210.897: Capstone II: Project Management 3 One elective course (two credits) must be taken in the first year 2 Total Credits for Year 1 19 Semester 4 210.802: Advanced Nursing Health Policy 3 210.806: Health Economics and Finance 3 210.804: Organizational and Systems Leadership 3 Semester 5 210.898: Capstone III: Implementation 3 210.807: Clinical Data Management 1 2 Semester 6 210.808: Clinical Data Management 2 2 210.899: Capstone IV: Evaluation 3 One elective course (two credits) must be taken in the second year 2 Total Credits for Year 2 21 TOTAL CREDITS FOR PROGRAM 40 2
Table 2. DNP PROGRAM OF STUDY CLASS OF SUMMER 2017 Semester Course # of credits 210.800: Foundation for Scholarship 2 Semester 1 (Fall 2015) 210.896: Capstone I: Mentored Scholarship 3 Semester 2 (Spring 2016) 210.803: Nursing Inquiry for EBP 3 210.801: Analytic Approaches 3 Elective: English for Academic Writing 2 Semester 3 (Summer 2016) 210.802: Advanced Nursing Health Policy 3 210.806: Health Economics and Finance 3 Total Credits for Year 1 19 Semester 4 (Fall 2016) 210.805: Translating Evidence To Practice 3 210.897: Capstone II: Project Management 3 One elective course 2 210.804: Organizational and Systems Leadership 3 Semester 5 (Spring 2017) 210.898: Capstone III: Implementation 3 210.807: Clinical Data Management 1 2 Semester 6 210.808: Clinical Data Management 2 2 210.899: Capstone IV: Evaluation 3 One elective course optional 2 Total Credits for Year 2 21-23 TOTAL CREDITS FOR PROGRAM 40-42 3
COURSE DESCRIPTIONS FOR CORE COURSES NR.210.800: FOUNDATIONS FOR SCHOLARSHIP This on-line seminar facilitates return to academic work. Students learn the essentials of effective scholarly writing and logical presentation of ideas. Students learn about writing well, evaluate the writing of others, and apply lessons learned to their own original scholarly writing. Course objectives are accomplished by reading and critiquing professional writing, creating original documents, and integrating feedback to improve work. NR.210.801: ANALYTIC APPROACHES TO OUTCOMES MANAGEMENT This course prepares the student to analyze epidemiological, biostatistical, managerial, and other healthcare related data concerning individuals, aggregates, populations and organizational systems. Students learn business and economic procedures to analyze the cost effectiveness of initiatives to improve quality and safety of health care outcomes. Organization of relevant variables for incorporation in data bases, identification of appropriate analyses for health care-related questions, and synthesis of diverse approaches to understanding health problems in the literature are integrated into course work. NR.210.802: ADVANCED NURSING HEALTH POLICY This course examines the public and private sector function of creating and implementing nursing and health policy. The role of political, legal, ethical and social philosophy in defining nursing and health services is examined. There is continued development of student competence in analytic methods for the study of complex nursing and health policy issues. The course considers how policy made by different branches of government and various public and private organizations deeply affects nursing as a profession, its ability to deliver care and the impact on the areas of technology development, assessment and management; professional practice regulation; and patient outcomes management. NR.210.803: NURSING INQUIRY FOR EVIDENCE-BASED PRACTICE This blended course focuses on evidence-based practice as a form of nursing inquiry for doctoral practice. The conceptualization, definition, theoretical foundations, rationale and methods of evidence-based practice are evaluated, and related research described. Systematic reviews are critiqued, as a part of the search for and evaluation of evidence on a selected clinical topic of concern. This course provides the background for the second evidence-based practice course on translation of evidence.. NR.210.804: ORGANIZATIONAL AND SYSTEMS LEADERSHIP FOR QUALITY CARE This course facilitates leading, advocating, and managing the application of innovative responses to organizational challenges. Emphasis is placed on development and evaluation of care delivery approaches that meet the needs of targeted patient populations by enhancing accountability for effective and efficient health care, quality improvement, and patient safety. This course focuses on development of strategies to implement change initiatives, manage conflict, and manage the ethical dilemmas inherent in health care organizations. NR.210.805: TRANSLATING EVIDENCE TO PRACTICE This course follows Nursing Inquiry for Evidenced-Based Nursing Practice, and focuses on the integration and application of knowledge into practice. The translation of evidence into practice, including the theoretical and practical challenges is analyzed through the use of case studies. Theories of change, caring, human needs and value systems, financial, ethical and social implications are considered in the translation of evidence into practice. Translation methods, including informatics, reorganization, work flow, and other approaches are discussed. Dissemination strategies are applied to proposed improvements in practice and clinical care outcomes. 4
NR.210.806: HEALTH ECONOMICS AND FINANCE Using economic intuition and logic, this course analyzes the diverse factors which influence the production and distribution of health care services. The course also explores methods of financing health care. Economic policy, health care regulation, and the impact of both on the health care industry and society are explored. Budgeting and cost evaluation are examined. Major topics include: health care system as a market; health care production functions; supply and demand for health care services; health and social insurance; resource allocation; competition and regulation; and the financial management of resources NR.210.807: CLINICAL DATA MANAGEMENT I Clinical data management is an essential component of evaluating any Evidence Based Practice / Performance Improvement project. A high caliber data management plan and its implementation will provide key stakeholders and decision-makers with the information necessary to make decisions about the value and continuance of each evidence-based intervention. Components of high caliber data management include clearly identified outcomes linked to variables and data sources; appropriate data collected for the purpose of measuring these outcomes; adequate statistical power to determine success of the project; proper data cleaning and manipulation techniques; appropriate statistical methods for measuring the outcomes; and a meaningful presentation of outcomes that addresses the concerns and questions of key stakeholders. The clinical data management course will provide students with the knowledge and skills necessary to develop and execute the data management plan for the capstone project. In Clinical Data Management 1, the data management plan and sample size determination are refined. Data collection for the Capstone project is in the beginning stages and data management focuses on data collection techniques, cleansing of data, and manipulation of data. Data governance is explored in detail and students interpret data governance policy related to their project and distinguish the ways in which they are adhering to their own data governance plan. Students begin the process of exploratory data analysis using data collected to-date NR.210.808: CLINICAL DATA MANAGEMENT II In Clinical Data Management II students complete data collection for their capstone project. Data management focuses on the complete execution of the evaluation plan. Data cleansing and manipulation continue and are finalized. Exploratory data analysis is executed with the complete data set. In the exploratory phase populations are described in detail, characteristics and distributions of key variables are explored, and any bias or confounding effects are identified. Outcomes data analysis is completed as well as any adjustment for bias or confounding. Students then focus on interpretation and dissemination of results to meet the needs of various stakeholders in both written and oral formats. NR.210.896: CAPSTONE I: MENTORED SCHOLARSHIP This first semester course of the capstone experience will provide students with the foundation upon which to develop their scholarly project and their career as a DNP. With course faculty, advisor, and mentor guidance students will clearly define an important practice problem, the context in which it occurs, and its significance. They will formulate a plan to search and analyze available evidence to develop a scholarly and integrative statement of the problem. NR.210.897 CAPSTONE II: PROJECT MANAGEMENT The DNP translates evidence into practice with the goal of improving outcomes. This second course in the capstone sequence provides students with the tools and direction needed to develop a comprehensive project management plan which will guide the work of translation and the remainder of the capstone experience. This plan will establish clear aims, describe activities required to achieve those aims, provide a detailed description of the planned innovation, and state methods for evaluation. Risks to participants will be clearly described and plans to mitigate or manage risk developed. The need for IRB review will be determined along with organizational readiness for the proposed innovation. Students present and defend the project plan in a formal justification at the end of the semester. Approval by the faculty is required before 5
implementation begins. NR.210.898 CAPSTONE III: IMPLEMENTATION This capstone experience provides opportunity for the student to execute the project plan in collaboration with the sponsoring site in a way that assures fidelity with the findings in the evidence and the plan approved by the IRB. The experience reflects the interest of the student and is designed to meet individual interests and career goals. This advanced practice experience allows the student to learn to manage time and resources, assess implementation issues, and utilize communication and collaboration strategies while working with a clinical mentor and a diverse inter-professional team to implement the project plan. NR.210.899 CAPSTONE IV: EVALUATION This is the final component of the capstone experience. The course content, as in the other capstone experiences, reflects the interest of the student and is designed to meet individual student needs and career goals. This final course allows the student, with guidance from mentor and faculty, to complete the clinical project and finalize the scholarly written and oral report to disseminate and integrate new knowledge. The final products will reflect the student s ability to employ effective communication and collaboration skills, to take a leadership role, to influence health care quality and safety, to evaluate practice, and successfully negotiate change in health care delivery for individuals, families, populations, or systems across a broad spectrum of healthcare. THE E-PORTFOLIO An electronic portfolio, or e-portfolio, is a purposefully developed collection of documents (e.g., papers, projects, spreadsheets) that provides a repository of the student s progress in meeting academic program outcomes. At the individual level, the e-portfolio is used for students to showcase their work and demonstrate knowledge and skills toward achievement of course objectives. At the course level, the e- Portfolio is used for formative evaluation of course assignments and for summative evaluation of the learning objectives of the course. At the program level, the e-portfolio is used by faculty to gather examples of student assignments and for evaluation purposes. The e-portfolio serves as a tool to document and evaluate professional development and learning or synthesis of student s development and learning. The e-portfolio is provided by Blackboard and is accessible in the content section of each student s Blackboard home page. A guide for accessing and using the Blackboard e-portfolio is posted in the Academic Resources section of the Cohort Blackboard site. Students will use the e-portfolio to document their achievement in the DNP program. Table 3 provides a list of documents to be included in the e-portfolio to evidence the student s scholarship, performance, achievement, and original work. Items in bold font are to be submitted to the Capstone Advisor and Organizational Mentor after grading in advance of any presentation within or outside the School of Nursing and in advance of submission for publication. Specific requirements for these papers, presentations, and products are provided in the syllabus and the BlackBoard site for the respective course. 6
Documentation of clinical practice earned from the Master s degree in nursing NR.210.896 Capstone I Curriculum vitae Resume Practice hours for semester Problem Statement Paper TABLE 3: E-PORTFOLIO COMPONENTS AND REQUIREMENTS Semester I Semester II Semester III NR.210.803 Nursing Inquiry for EBP Individual Evidence Summary Tool Synthesis and Evidence Table Recommendation Tool Evaluation of the Evidence Paper Final PowerPoint presentation NR.210.897 Capstone II Project Plan Justification Materials Capstone Justification Formsigned e-form A NR.210.805 Translating Evidence Synthesis of Evidence Paper Semester IV Semester V Semester VI NR.210.804 Organizational and Systems Leadership Leadership Reflection NR.210.802 Advanced Nursing Health Policy Policy Exploratory Data Analysis Practice hours for semester NR.210.898 Capstone III Final Status Report Practice hours for semester NR.210.808 Clinical Data Management II Final summary of results NR.210.899 Capstone IV Draft of Capstone Project manuscript Final Defense Materials Updated Curriculum vitae Updated Resume Practice hours for semester and overall total Capstone Manuscript for submission to target journal DNP SCHOLARSHIP A high level of synthesis and integration is a defining characteristic of doctoral education at Johns Hopkins University. All instruction and experience is directed to develop a level of scholarship that will warrant award of a DNP degree from Johns Hopkins University. Students are required to demonstrate the ability to employ effective communication and collaboration skills in order to influence healthcare quality and safety, and negotiate successful change in care deliver processes for individuals, groups, or populations across a broad spectrum of healthcare delivery systems. To assure that students are progressing in their development of deep and comprehensive understanding, scholarly papers are required across the curriculum. The student is responsible and accountable for developing these papers as part of the coursework. It is expected that students will conduct significant, original projects which translate evidence into practice. Projects will focus on practice problems and/or organizational systems and promote effective, efficient and accessible care for individuals, groups, or populations. Each student has flexibility in developing a capstone project that meets his/her individual needs and career goals. Preparing for, implementing, and evaluating an intervention based on evidence provides an opportunity for the student to apply advanced empirical, theoretical, leadership, and specialty knowledge and skills to clinical practice and systems level experiences. The findings of these projects have implications for policy and practice. The student s DNP Capstone work is conducted under the direction of a faculty serving as the DNP Advisor and an individual within the student s organization who has agreed to serve as an advocate and facilitator, that is, the Organizational Mentor. Students work closely with these members of the DNP Project Team throughout their program of study. 7
DNP Project Team DNP Advisor: A ranked faculty (Assistant Professor and higher) assists the advisee in obtaining information and making decisions related to progression through the program. The DNP Advisor serves on the student s DNP Project Team ensuring that the Capstone project meets the expected criteria for the practice-level doctorate. DNP Faculty Project Team Member: A faculty member holding a doctoral degree and appointment as Instructor or with rank, serves as an additional faculty member of the DNP Project Team. Organizational Mentor: The DNP Capstone project is typically conducted in the organization where the student is currently employed. The Organizational Mentor is an individual who can assist the student throughout the capstone process, from problem definition to project planning to project implementation and to evaluation. The Organizational Mentor is the internal facilitator, assisting the student as needed to remove barriers and facilitate the process within the organization or setting in which the project is conducted. The Organizational Mentor serves as advocate/facilitator for the DNP student and a liaison for the organization to the Johns Hopkins School of Nursing. These members of the DNP Project Team should be considered by the student as potential co-authors on manuscripts that may be derived from completed / graded papers. The student must be the first author on papers generated as part of the DNP program. The student should generate at least one publication related to the Capstone that is co-authored with the DNP Advisor; other co-authors should be considered based on their contributions to the work, such as the Organizational Mentor, other faculty and Project Team members, and colleagues in the organization where the capstone was conducted. The student progression through the conduct of the Capstone project and DNP Program is monitored through formal presentations, including the Capstone Justification and Capstone Defense. CAPSTONE JUSTIFICATION The Capstone Justification serves to assure quality of scholarship, safety for patients and staff, rigor of methods and analytics, and ethical behavior of students during the capstone project. Through this formal presentation and the responses to questions from the Justification Panel, chaired by the student s DNP Advisor, the student is evaluated on the following criteria: 1. The problem is significant; 2. The project is sufficiently scholarly and rigorous to satisfy program requirements; 3. The work is original; 4. The scope is appropriate for doctoral study; 5. The student has planned in sufficient detail to manage a complex project; 6. Any risk is identified, minimized, or managed appropriately; 7. The design and methods are appropriate to achieve the project aims; 8. The plan for data collection and statistical analysis are congruent with the project aims; 9. The project is feasible. STUDENT RESPONSIBLITIES Complete all requirements from Year 1 for the DNP Curriculum with a grade of B or higher. Establish the time of the Justification with the DNP Program Administrator and DNP Project Team members, including the DNP Advisor and Organizational Mentor. Obtain approvals for proceeding, at least 3 weeks prior to the scheduled date of the Justification, from the Capstone II faculty, the DNP Advisor and Organizational Mentor. These approvals are based on the preliminary Project Plan. Prepare a presentation that is 20-30 minutes in length. The student submits a final electronic copy of the Capstone Project Justification presentation and the complete Project Plan to the DNP Program Administrator and all members of the DNP Project Team two-weeks prior to the 8
presentation. Provide a print copy of the presentation to distribute to the Justification panel (DNP Advisor, DNP Project Team faculty member, Organizational mentor, and at least one additional DNP faculty member). CAPSTONE DEFENSE AND ORAL EXAMINATION The Capstone Defense and Oral Examination serve to test the depth and breadth of the student s knowledge, reasoning abilities, decision making, and leadership in areas related to the Capstone Project. Successful completion demonstrates completion of the Capstone Project. The Capstone Defense and Oral Examination is conducted near the end of Semester 6, but with sufficient time for the student to complete any requirements within a timely manner before the semester end. Through this formal presentation and the responses to questions from the Justification Panel, chaired by the student s DNP Advisor, the student is evaluated on the following criteria: 1. Advanced clinical judgment, expertise and specialization in a defined content area. 2. Advanced levels of systems thinking and accountability in designing, delivering, and evaluating evidence- based care to improve healthcare quality, safety, and outcomes. 3. Leadership in the development and implementation of patient-driven, institutional, local, state, federal, and/or international health policy in a select content/specialty area. 4. The uses of leadership skills to design, direct, implement and execute a scholarly Quality Improvement project. STUDENT RESPONSIBLITIES Complete all requirements from Year 2 for the DNP Curriculum with a grade of B or higher. Submit final draft of Capstone Project Manuscript following evaluation and grading by DNP Capstone IV faculty to DNP Advisor and Organizational Mentor as evidence of and confirmation for readiness for DNP Capstone Defense. Establish the time of the Justification with the DNP Program Administrator, DNP Advisor and Organizational Mentor. Prepare a presentation that is 20-30 minutes in length to be given at (1) the Organization/Agency/Practice where the Capstone Project was presented, and (2) the Johns Hopkins School of Nursing (JHSON). Submit a final electronic copy of the Capstone Project Manuscript to the DNP Program Administrator and all members of the DNP Project Team two-weeks prior to the presentation. Provide a print copy of the presentation to distribute to the Defense panel (DNP Advisor, DNP Project Team faculty member, Organizational mentor, and at least one additional DNP faculty member). CAPSTONE JUSTIFICATION AND CAPSTONE DEFENSE PROCESS 1. The DNP Advisor presides at the presentation beginning with a review of the purpose and introduction of the student 2. The DNP student delivers a 20-30 minute presentation which is followed by up to 30 minute question and answer period. 3. The DNP faculty Project Team member and Organizational Mentor engage in private deliberation with the DNP Advisor, who manages the decision process (pass, conditional pass, fail), completing the relevant document (i.e., Capstone Justification Evaluation Form, Capstone Defense Evaluation Form). 4. The DNP Advisor relays results to student and reviews the feedback from the DNP Project Team. 5. The DNP Advisor obtains signatures for and provides student with a copy of the Capstone Justification Evaluation Form to upload to e-portfolio. 6. Submits Evaluation Form to DNP Program Administrator for inclusion in student s file and report to the DNP Progressions Committee. 9