Overview of DNP Project and Residency

1. Overview of DNPProject and Residency Robin Bissinger, PhD, APRN, NNP-BC, FAAN Associate Dean of Academics Medical University of South Carolina College of Nursing

2. DNP Program • Full or Part time plan of study • Signed and agreed to by the student • If you change from FT/PT or PT/FT we have to revise and sign a new plan of study • This can delay graduation in some cases • Your program plan is used to register for you for your courses each semester • Any questions related to your program come to Arly Douglass GiGi Smith. Dr. Smith is the Director of the program and your program advisor. • Course issues are addressed first with faculty and if you cannot resolve the issue contact Dr. Smith. • Check your MUSC email daily for information • Meet all mandatory's such as BCLS and Catts or you will be out of your courses

3. Practice Improvement Project • Use of research knowledge and methods to create, implement and evaluate practice interventions, health delivery systems, and clinical teaching. • Commitment to translate research into practice in order to improve health care outcomes • Project in an area of clinical practice, expertise or interest • A practice change initiative • Program implementation and evaluation • Practice model implementation and evaluation • Health policy implementation • Quality improvement project

4. Guidelines Project is related to advanced practice in the nursing specialty and benefits a group, population or community rather than an individual May be done in partnership with an agency or group but student must have the leadership role or can be solo Students work with a clinical expert or mentor and the Residency Faculty Must go through IRB at MUSC and your center Ask yourself “What population or outcome will you impact with this change” and how will you know….what data will you look at pre and post change.

5. PIP Framework • Focus-PDSA approach • F: Find a process to improve • What do you plan to change • Organize an effort to work on improvement • Who will be involved and what support do you need • Clarify the current knowledge of the process • What is the current state of the science related to the process or practice • Understand process variation and performance capabilities • Outline specifically how the current process works • Select changes aimed at performance or process improvement • Choose the intervention or interventions • What changes are you going to make

6. PIP Framework • Plan the change. Analyze and predict the results • How do you plan to measure the effect of the change • Do it • Execute the plan taking small steps in controlled circumstances • Study it • Check or study the results • Act: Take action • How do you sustain the gain • If no working what is the next step (Continue PDSA)

7. Residency • Key component of the DNP Program • Combines clinical practice experiences with scholarly activities (400 total hours for a total of 1000 hours) • Some students will need more hours to reach the 1000 based on their MSN program • Two components • Comprehensive clinical experience • 300 Precepted Hours • Broadens exposure in your APN specialty • Does not provide a new specialty • Practice Inquiry Project • 100 hours • Cannot begin this project until you are in residency

8. Residency • Individually designed by each student • Set your own clinical goals • Approved by Residency Coordinator • Demonstration of increasingly complex and proficient practice • Clinical hours • Procedural

9. Residency • Refined communication, reflection and scholarly skills • MyFolio • Reflective Journaling • Scholarly Activities • Competencies • Patient care expertise with emphasis on independent and inter-professional clinical practice • Typhon clinical logs for patient clinical • Clinical and Preceptor contracts • Health Policy and Health Care delivery Projects

10. Clinical Residency • Clinical Site • Clinical Site Approval form • Faxed to Graduate Program Coordinator (Douglass) • Goes to Residency Coordinator for Approval • Once site approved: Affiliation Agreement Request Form • Faxed to Graduate Program Coordinator • Must have Legal facility agreement to start residency work • Clinical Preceptor • With expertise in clinical practice and Nationally certified • Complete clinical preceptor form, attach CV, copy of license and certification • Faxed to Graduate Program Coordinator: Douglass

11. Residency Contract • Purpose of residency is to increase exposure to doctoral level clinical practice • DNP Clinical Residency Contract • Specific objectives, requirements and evaluation criteria • Specified number of hours for each contract • Completion of contract to successfully meet residency requirement • Final decision by residency course coordinator • Contract must be developed by the student and agreed on by clinical preceptor and residency course coordinator • Signed by the student, clinical preceptor and residency course coordinator. • Placed in academic record • Must demonstrate completion of contract and upload to my-folio unless in Typhon • Contracts for Spring residency already due • Contracts can take the entire semester so get started

12. Reflective Journal • Integration of clinical leadership and inquiry into previous or current practice • Utilize clinical cases from your experience or practice • Integration of ethics, genetics, heath policy, collaboration and information technology, health disparity and other areas of doctoral level practice • This is a tangible, deliverable academic product • Example • Identify a potential genetic risk in a population of patients you have cared for and discuss a diagnosis of a genetic condition and an intervention you made for an individual in your practice. Discuss the implications for the families. What did you learn from the experience? Would you do anything different? Provide a critical analysis and discussion. • Done in MyFolio under Reflective Journaling

13. Scholarly Activities • Academic and Scholarly activities • Conferences, seminars, journal club, grand rounds, morbidity and mortality, patient conferences, quality and safety, practice-based lectures, interdisciplinary committees, quality improvement committees, policy or advocacy events • Each student is expected to document a minimum of 10 activities during the program. Can be done at any time in the program. • On My-Folio: under Residency you will find this section

14. Residency Competencies • Domains and Competencies for DNP education and APRN practice must be met within the program. • These are the skills, knowledge and attitudes required for clinical practice (referred to as competencies) • Some are met in course work • Others are met by students with documentation provided by you in MyFolio • Each Domain and competency is outlined in MyFolio • Required to review competencies and complete any tasks • Example • Competency 22: Counsels the patient on the use of complementary/alternative therapies (see task) • In one paragraph describe how you counseled a patient on the use of complementary therapies.

15. Residency Evaluation • Evaluation of Clinical site • Evaluation of Clinical Preceptors • Evaluation of Residency Course • Evaluation of Residency Course Coordinator • Preceptor evaluation of you • Long and short forms • Long forms are required for clinical contracts over 50 hours

16. Residency I Only 1 credit hour Students asking to get started sooner Obtain site and preceptor contracts now Develop a goal for first residency contract to grow in your APRN role

17. Residency II • Project cannot be started until you have IRB approval and you must be in your residency course • Project • Upload 5 page edited paper with changes in my-folio • Share this with your residency faculty • Choose your journal • Write first section of your paper up to results/conclusion • Stay on time-line and redo it if delay in IRB • Complete half of your clinical hours • Insure clinical contracts are completed, hours verified and upload • Complete half of your scholarly activities, reflective journaling and competencies

18. Residency III • Project • Write final paper, obtain faculty approval and send to journal • Upload journal has received it • Upload paper that was sent for publication • Develop poster and seek approval prior to presentation • Meet with statistician early if needed • Complete remaining clinical hours • Insure clinical contracts are completed • Complete remaining scholarly activities, reflective journaling and competencies • If any delays discuss need for another residency

19. Program Milestones Completion of Project Completion of MyFolio: All components Residency: Completion of all 400 hours

20. Final Project Work • Final proposal is completed in Practice Inquiry and IRB • First draft of paper that outlines project is reviewed by faculty and uploaded after all changes are made • Final paper and poster are due in your last residency (NRDNP 890) • Two weeks prior to the poster presentation • All sections of MyFolio must be complete • Publication must be approved and all revisions made • Poster presentation • Electronic publication must be uploaded with proof of submission to journal • Poster is presented with a 10 minute oral-summary • Committee signs off on your work with recommendation for the DNP degree

21. Contact us • Stay in touch • Send emails with questions and concerns • Consider being on the Graduate Program Committee and EPEC committee to represent your group • If you are struggling call early so we can help • Understand one thing: • “Our Goal is that everyone will graduate, do well and represent the CON as a strong APRN leader” • Follow up with us after graduation: Alumni survey, employer survey and graduation survey

22. QUESTIONS?