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School of Nursing. DNP Advanced Practice: Challenging the Definition. Judith F. Karshmer, Ph.D., PMHCNS-BC Dean, School of Nursing University of San Francisco. Learning Objectives. Objective 1 : Discuss the scope of DNP practice outside the clinician role.

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School of Nursing

DNP Advanced Practice: Challenging the Definition

Judith F. Karshmer, Ph.D., PMHCNS-BC

Dean, School of Nursing

University of San Francisco



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Learning Objectives

Objective 1: Discuss the scope of DNP practice outside the clinician role.

Objective 2: Discuss the relationship between the “indirect” DNP competencies and those of the “direct” clinician role.

Objective 3: Incorporate a comprehensive definition of advanced practice into the DNP dialogue.

Educating Minds and Hearts to Change the World


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Advanced Nursing Practice:

  • any form of nursing intervention that influences health care outcomes for individuals or populations, including the direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy (AANC).

Educating Minds and Hearts to Change the World


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DNP Essentials

  • Like PhD or MSN - does not designated a specialty

  • DNP Essentials = core to all advanced practice nursing practice roles

  • Depth and focus of the core competencies will vary based on the particular role for which the student is preparing.

Educating Minds and Hearts to Change the World


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Essentials: Two Components

  • DNP Essentials 1 - 8 are the foundational for all DNP graduates regardless of specialty or functional focus

  • Specialty competencies/content prepare the DNP graduate for a particular specialty

Educating Minds and Hearts to Change the World


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DNP Essentials

Essential I: Scientific Underpinnings for Practice

Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking

Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice

Essential IV: Information Systems/ Technology and Patient Care Technology for the Improvement and Transformation of Health Care

Educating Minds and Hearts to Change the World


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DNP Essentials

Essential V: Health Care Policy for Advocacy in Health Care

Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes

Essential VII: Clinical Prevention and Population Health for Improving the Nationユs Health

Essential VIII: Advanced Nursing Practice

Educating Minds and Hearts to Change the World


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The ISSUE…

  • Definition versus “default” implementation

  • Literature argues the need for DNP preparation for advanced practice related to:

    • the importance of leadership

    • the demands associated with increasingly complex health care system

    • the need for developing expertise in inter-professional practice, information systems, quality improvement, and patient safety in order to promote health care emphasizing evidence-based practice

Educating Minds and Hearts to Change the World


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YET…

  • Examples and discussion of advanced practice almost ALWAYS default to the clinician role…

    • NP

    • CNS

    • CNM

    • CRNA

Educating Minds and Hearts to Change the World


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Consequences

This is a disservice to the profession and advancing the DNP degree

  • Continued confusion

    • DNP only for clinician

    • Advanced practice is only for those who work directly with patients

Educating Minds and Hearts to Change the World


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  • Nursing leaders “left out”

    • Implications that their practice is not Advanced Practice

  • Must include:

    • CNO/CNE

    • Policy Leaders

    • Magnet Coordinators

    • Bioethicist

    • Health Care Consultants

Educating Minds and Hearts to Change the World


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Challenge:

  • Nurse Educators: Demand of ourselves that we advance the “indirect role”

    • Curricula

    • Publications

  • DNPs: Expand the dialogue to be inclusive

  • Programs: Interprofessional must pertain within nursing

Educating Minds and Hearts to Change the World


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Advance the AACN Definition

  • any form of nursing intervention that influences health care outcomes for individuals or populations, including the direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy.

Educating Minds and Hearts to Change the World


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Thank You

Educating Minds and Hearts to Change the World


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