DNP Program Outcomes and Impact on Practice

1. DNP Program Outcomes and Impact on Practice Elizabeth F. Fuselier, DNP,RN,APRN, BC Family Nurse Practitioner University of Tennessee Health Science Center, Memphis, TN

2. Professional Evolution • National Accounts Representative in Workers Compensation 1988-1991 • FNP Practicing in Rural & Occupational Medicine in MS and TN 1996-1998 • Lead Nurse Practitioner, Ochsner Clinic Foundation(OCF), New Orleans, LA 1998-2005 • Clinical Practice, Department of Internal Medicine, Emergency Medicine and Pediatrics at OCF 1998-2205

3. Responsibilities as Lead NP • Developed a practice model of NP utilization throughout OCF • Created NP practice opportunities in all departments except plastics and dermatology • Liaison for NPs to hospital and clinic administration

4. Responsibilities cont.(1) • Created and implemented credentialing, hiring, and orientation policies • Developed evaluation and competency policies and tools • Liaison to state, national, governmental and professional organizations • Served on medical residency guidelines committee

5. Responsibilities Cont. (2) • Advocated for and increased NP compensation, scope of practice, and educational opportunities within OCF and statewide. • Managed over 40 NPs, increased overall staffing to 120 APRN’s • Worked with Lead Physician Assistant, CRNA, and NNP to continue advancement of practice at OCF

6. Transformation of Practice • OCF became accredited as a MAGNET hospital in 2003 • Evolution from problem based healthcare to evidenced based patient and outcome focus model • Clear mandates for increased nursing research, and clinician skill set to assess, incorporate and evaluate evidenced based clinical practice

7. Transformation Cont. (2) • Medical Residency restrictions developed and enforced • Became clear that a transformation for NP practice was needed and opportunity was there • In effort to lead, I had to lead by example • Needed to become a clinical expert beyond the masters level

8. Transformation of Personal Practice Model • MSN skill set was in place, but a void in broader repertoire of critical thinking and evaluation skills existed • Decision to seek a doctoral level education was made • Evaluation of available doctoral programs was made

9. Making the Right Choice • Chose University of Tennessee : • Practice focused Doctorate • Distance learning program online • 1:4 Ratio • 970 clinical hours • DNP offered a cross sectional didactic, clinical, and administrative toolbox for advancement to a higher level of clinical scholarship and practice • DNP offered a practical model

10. The Right Choice (cont)2 • Program offered structured clinical experience at a higher level than the MSN to develop broader evidenced based scope of practice • Provided the working language of bench and clinical research • Fostered the development of a broader array of analytical, theoretical, philosophical and evaluative processes

11. The Right Choice (3) • The DNP provides the principles and lived experiences to become a nurse leader in clinical,academic, administrative, community and policy making arenas • The DNP provides the didactics for one to become a change agent to transform advanced nursing practice

12. Lessons From the Front • Faculty provided critical networking resources to allow for superior clinical electives and residencies • Facilitated access to broad opportunities and exposure to exemplary nursing leaders across the healthcare spectrum

13. Impact on Current Practice • Appointed the first full time DNP faculty position at the University of Texas Health Science Center-Houston, November 2005 • Assistant Professor in the Department of Acute and Continuing Care

14. Appointment Cont(2) • Appointed Executive Clinical Director of University of Texas Health Services • Will participate in committee to develop innovative DNP and APRN practice opportunities

15. “Leadership Is both something you are and something you do” Fred smith