Career development of doctorally prepared nurses.

AIM: To integrate research literature regarding careers, career development and factors influencing the career development of doctorally prepared nurses. DESIGN: An integrative review. DATA SOURCES: Medline, CINAHL and Embase were searched in June 2022 without time restrictions. METHODS: Peer-reviewed empirical publications written in English with different types of study designs were included. Two researchers independently applied eligibility criteria, selected studies and conducted quality appraisals using Joanna Briggs checklists. Data were extracted and analysed using a convergent integrated approach with thematic analysis. Themes were established within three categories based on the research questions: career, career development and factors influencing career development. RESULTS: Twenty-two studies were included. Nine themes were identified. One theme regarding careers describes that doctorally prepared nurses need to prioritize work within different positions. The two themes focusing on career development described the need to determine career goals after the doctorate and further develop competencies. Six themes described factors influencing career development: 'Intrinsic motivation to improve health care and nursing education', 'Available support sources', 'Professional development programmes', 'Work-life balance', 'Organizational infrastructures for career advancement' and 'Competition and hostile treatment among colleagues'. CONCLUSION: Limited knowledge of the careers and career development of doctorally prepared nurses was found. Doctorally prepared nurses need to balance work with various part-time positions. Careers and career development could be supported by the development of structures for career advancement as well as supportive working environments. IMPACT: Doctorally prepared nurses with strong careers are important to health care and nursing as they generate and implement new knowledge into clinical practice and thereby support the improvement of (nursing) care and patient outcomes. This study provides considerations towards strengthening the careers of doctorally prepared nurses. REPORTING METHOD: PRISMA. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Current state and future recommendations for faculty in PhD in nursing programs.

In 2020 the American Association of Colleges of Nursing (AACN) Board of Directors appointed a 9-member task force to revise AACN's 2010 position statement, The Research-Focused Doctoral Program in Nursing: Pathways to Excellence, with the goal of developing a vision for research-focused doctoral programs and graduates. This resulted in 70 recommendations in a new AACN position statement, The Research-Focused Doctoral Program in Nursing: Pathways to Excellence (2022). The new document is based on a review of the literature from 2010 to 2021 and 2 inaugural surveys sent to deans and PhD students in nursing. The new The Research-Focused Doctoral Program in Nursing Pathways to Excellence document focuses on the critical need for nurse scientists who can develop the science, steward the profession, and educate new nurse educators. Several manuscripts have been developed describing various components of the PhD Pathways document focusing on the role of faculty, students and curriculum, resources and post-doctoral education. This article focuses on the recommendations related to explicating the faculty role in PhD education and includes data from the AACN (2020) deans' survey, the current state of the professoriate involved in PhD education and the developmental needs of PhD faculty for the future.

Inclusive leadership to guide nursing's response to improving health equity.

The purpose of this manuscript is to examine traditional models of leadership in nursing, and to provide a roadmap and specific recommendations for nurses at all levels to lead our profession through the next decade in achieving health equity. We examine current leadership frameworks in nursing and discuss ways to contemporize these frameworks to more explicitly center the expertise of clinicians and communities from historically marginalized backgrounds. Next, we examine the racial, gender, and able-bodied biases that impact nurses, and call upon nurses to examine and dismantle these biases. We discuss the roles of health systems and academic organizations in developing inclusive leaders, including through community engagement and true service-learning partnerships. Finally, we provide a set of recommendations for all nursing leaders across career stages to embrace inclusivity as they work to improve health equity.

Publishing in Predatory Journals: Guidelines for Nursing Faculty in Promotion and Tenure Policies.

PURPOSE: The purpose of this study was to assess the extent to which academic promotion and tenure (APT) criteria and guidelines in schools of nursing recognize predatory publishing. This assessment included an analysis of APT documents looking specifically for guidance about predatory publications by faculty in schools of nursing. DESIGN: This study used a cross-sectional, descriptive design and was conducted in 2020. METHODS: A mixed methods approach was used to collect data from two sources. Data were extracted from APT documents for 92 research-intensive universities found online and specifically focused on documents for universities and for schools of nursing in the United States. Interviews were conducted with a subsample of academic administrators (n = 10) from selected schools. FINDINGS: The majority (57%; n = 50) of APT documents reviewed addressed quality of the journals in which faculty publish. However, very nonspecific terms, such as "high quality" or "peer reviewed" were used. None of the documents reviewed (n = 88) included any reference to predatory journals. Deans who were interviewed validated the analysis of the APT documents. While most deans reported faculty were aware of predatory journals and the risks of publishing in them, formal guidelines for consequences for publishing in predatory journals were not developed or available. CONCLUSION: This study examined how schools of nursing in research-intensive universities address the issue of predatory journals. APT criteria do not provide guidance to faculty and promotion and tenure committees about issues related to predatory publications as low-quality publication outlets. Recommendations for APT committees, mentors, and faculty are provided. CLINICAL RELEVANCE: Clinicians rely on researchers, many of whom are faculty, to publish rigorous studies that produce evidence they can translate into practice. One measure of the quality of a study's findings is where the paper is published and reflects the level of peer review it has been through. Faculty who publish in predatory journals may not have had their work reviewed by experts; evidence produced may or may not be adequate for translation to guide nursing practice.

Innovations in Ph.D. education to prepare nurse scientists for the future.

The University of Pennsylvania sponsored a PhD summit in October 2019 to bring together faculty and leaders in PhD education as well as professional associations in nursing to discuss the state of PhD education. Participants were divided into groups and asked to address specific questions. This paper presents the discussion points and recommendations from the group focusing on innovation in PhD education. Innovations such as team mentoring models, design thinking courses, and structures that support students to progress from BSN through PhD programs are discussed. Recommendations include a need to intentionally structure faculty development earlier in their professorial careers, develop team models of advisement and longitudinal follow-up of alumni graduates form Ph.D. programs to examine the effectiveness of innovations.

An innovative DNP post-doctorate program to improve quality improvement and implementation science skills.

BACKGROUND: Doctor of Nursing Practice programs prepare nurse leaders for unique roles to address healthcare needs across the quality spectrum. However, additional mentoring and training in implementation science and analytical skills is needed to effectively lead system-wide quality initiatives. PURPOSE: The purpose of this article is to describe the planning, implementation, and evaluation of an innovative post-doctoral DNP Quality Implementation Scholars Program developed through an academic-practice partnership to address this need. PROJECT METHOD: Throughout the one year post-doctoral program, we evaluated student experiences qualitatively using focus groups and quantitatively using standardized course and instructor surveys to assess overall programmatic goals. Program outcomes were evaluated from the perspective of the academic-practice partnership planning committee through a Qualtrics© survey. FINDINGS: Strengths of the program included the in-depth mentoring by faculty and relationships built across the larger health system. Both scholars and the planning team noted that the system-wide project implemented by the scholars was relevant, timely, and quality-focused. CONCLUSIONS: This innovative DNP post-doctoral program leveraged the skill-sets of DNP-prepared nurse leaders to lead system-wide quality improvement initiatives tailored specifically to healthcare organizations.

Advancing Nurses' Role to Address Issues Facing Japanese Anesthesia Practice.

Japan is challenged with unique social problems because of its declining birthrate and rapidly aging population. By the year 2025, all of Japan's baby boomers will be 75 years or older, making Japan a "superaging" society. Japanese healthcare expenditures are rapidly climbing because of the need for increasingly complex medical-surgical treatments for this aging population. In addition, a major shortage of anesthesiologists has produced serious threats to patient safety, as well as to quality and timeliness of surgical care. In an attempt to meet the demand for anesthesia services and to ensure access and quality care, the Japanese Ministry of Health, Labor and Welfare has identified a potential role for nurses as anesthesia practitioners, as an innovative solution. Nurse and physician educators in Japan have begun educating and training nurses in the practice of anesthesia; however, nationally recognized licensure or certification does not yet exist for graduates of these programs. The purpose of this article is to review the unique challenges facing Japan's anesthesia practice and to make recommendations about the potential introduction of nurse anesthetists in Japan.

Depression Screening and Measurement-Based Care in Primary Care.

The health issue addressed is the unmet need to universally screen and treat depression, which is one of the most common mental health disorders among adults in the United States. The US Preventive Services Task Force recommends screening adults for depression in primary care and using evidence-based protocols. This quality improvement project implemented VitalSign6, a measurement-based care program, to improve depression screening and treatment of adults in primary care at an academic medical center. A pre-post design was used to determine effectiveness of changes in screening, outcomes, and satisfaction. Of 1200 unique adult patients, 95.4% received initial screening. Providers diagnosed and administered measurement-based care to 236 patients. After 14 weeks, 27.5% returned for at least 1 follow-up. Results showed a statistically significant decrease in self-reported depression scores from baseline to follow-up. VitalSign6 was effective in improving identification and management of depression in primary care.

Creating a culture that values diversity and inclusion: An action-oriented framework for schools of nursing.

An organizational culture that values diversity and inclusion is essential for the achievement of high-quality nursing education, yet little literature exists to guide schools of nursing (SON) in accomplishing this goal. All SONs, regardless of size, need a framework that provides specific steps for developing and nurturing a culture that values diversity and inclusion. Using our SON as an exemplar, the goal of this article was to (a) review the barriers we faced when building a diverse and inclusive environment, (b) share our school's strategic plan designed to promote diversity and inclusion, and (c) highlight successful strategies as part of the development and ongoing implementation of our school's strategic plan. This process requires continuous commitment and intentionality as well as flexibility to address unforeseen circumstances. For example, the goals we have adopted and the strategies we have put in place have allowed members of our SON community to acknowledge and address the urgency and validity of the Black Lives Matter movement, as well as the disproportionate impact of the coronavirus disease 2019 pandemic on racial and ethnic minority groups. Although we recognize that we still have work to do within our SON community, we believe our exemplar offers an action-oriented framework for increasing diversity and inclusion among students, faculty, staff, and leadership in SONs.

Low-Dose Computed Tomography: Effects of Oncology Nurse Navigation on Lung Cancer Screening.

BACKGROUND: Low-dose computed tomography (LDCT) lung cancer screening is an evidence-based and reimbursable strategy to decrease lung cancer and all-cause mortality in qualifying patients, but there remains low use and variation in providers' LDCT screening, ordering, and referring knowledge. OBJECTIVES: The purpose of this quality improvement project was to examine the effects of oncology nurse navigation on assisting patients and ensuring optimal LDCT lung cancer screening. METHODS: Oncology nurse navigators conducted LDCT provider education and navigated 133 eligible patients to LDCT during a five-month intervention time period. FINDINGS: Provider education resulted in improved documented tobacco cessation discussions and increased LDCT screening ordering fidelity. Mean days from LDCT to provider notification and mean days from LDCT to patient notification improved significantly.

Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track.

BACKGROUND: In 2004, the American Association of Colleges of Nursing (AACN) called for all nursing schools to phase out master's-level preparation for advanced practice registered nurses (APRNs) and transition to doctor of nursing practice (DNP) preparation only by 2015. Today, five years after the AACN's deadline, nursing has not yet adopted a universal DNP standard for APRN practice entry. PURPOSE: The purpose of this paper is to examine the factors influencing the ability of nursing schools to implement a universal DNP standard for APRNs. METHODS: Deans from top-ranked nursing schools explore the current state of the DNP degree in the US. The authors draw upon their collective experience as national leaders in academic nursing, long-time influencers on this debate, and heads of DNP programs themselves. This insight is combined with a synthesis of the literature and analysis of previously unpublished data from the AACN on trends in nursing doctoral education. FINDINGS: This paper highlights issues such as the long history of inconsistency (in messaging, curricula, etc.) surrounding the DNP, certification and accreditation challenges, cost barriers, and more. The authors apply COVID-19 as a case study to help place DNP graduates within a real-world context for health system stakeholders whose buy-in is essential for the success of this professional transition. DISCUSSION: This paper describes the DNP's standing in today's professional environment and advances the conversation on key barriers to its adoption. Insights are shared regarding critical next steps to ensure national acceptance of the DNP as nursing's terminal practice degree.