Assessment of nursing faculty retirement projections.

BACKGROUND: Nursing faculty retirement is a critical factor contributing to the nursing faculty shortage. PURPOSE: To assess the accuracy of projections on 2016 to 2025 nursing faculty retirements made in a previous study by Fang and Kesten (2017). METHODS: The 2016 to 2022 full-time nursing faculty data collected by American Association of Colleges of Nursing were used to examine the accuracy of the retirement projections for the same years. DISCUSSION: The study found that the mean age of full-time nursing faculty decreased for the first time; the number of faculty retirees and their age distributions projected by Fang and Kesten (2017) were accurate; there was a larger loss of nursing faculty at senior ranks to retirements than was anticipated; nursing faculty aged 50 to 59 in 2015 have made significant progress in doctoral attainment, senior rank, and graduate-level teaching by 2022, but they were still underrepresented in senior ranks compared to the 2016 to 2022 retirees; and for nursing faculty with a PhD degree, their growth was slower than their loss to retirements. CONCLUSION: The findings demonstrate the usefulness of the specific methods for faculty retirement projections. The decline in the mean age of nursing faculty is a positive sign that there is an increased recruitment of younger nurses into academia. The increase in the number of younger nurses entering academia with Doctor of Nursing Practice (DNP)-degree preparation can be leveraged through PhD-DNP collaboration to prepare practice-ready nursing graduates who contribute to health care improvements. Nursing schools need to implement innovative strategies to mentor younger faculty for their successful succession.

Engaging Older Adults and Families Using the IDEAL Discharge Protocol: A Quality Improvement Initiative to Improve Outcomes and Reduce Readmissions.

Older adults have challenges understanding newly prescribed medications after discharge and must be more adherent with medications and follow up with their primary care provider. A collaborative discharge process is critical to improving patient outcomes and reducing avoidable readmission rates. This quality improvement (QI) initiative engaged 44 patients and families in the IDEAL Discharge Protocol-an evidence-based collaborative care process focused on discussion, education, and post-discharge follow up. Post-discharge follow up resulted in the completion of 52.2% of follow-up calls and 45.5% of follow-up appointments scheduled, and a 4% reduction in readmission rates. Medication adherence was assessed and found to be 93.3%, and 100% of participants received education while engaged in the study. The IDEAL Discharge Protocol aided in improving the discharge process to better equip patients with the tools to transition home successfully after discharge. [Journal of Gerontological Nursing, 49(10), 13-19.].

Just-in-Time Orientation of Non-Critical Care Nurses to the Critical Care Environment.

During the COVID-19 pandemic, non-critical care nurses assisted in the provision of care to critically ill patients. Just-in-time education was needed for these nurses to effectively assist in the care of these patients. A 12-hour educational program was offered to non-critical care nurses. During this multi-modal program, instructors delivered information to participants through unique didactic classroom learning, simulation engagement, and hands-on experience in a critical care unit. After completing this innovative program, participants demonstrated a significant improvement in knowledge, confidence, and perception of competence in caring for critically ill patients. Participants were highly satisfied with the program. Implementation of a just-in-time, multi-modal critical care nursing program is an effective method of providing non-critical care nurses with basic levels of skills, knowledge, and competency during a crisis to enable them to assist with providing care to critically ill patients. [J Contin Educ Nurs. 2022;53(10):465-472.].

Doctor of nursing practice scholarship dissemination through an open access repository.

Open access repositories have become more widely used for the dissemination of Doctor of Nursing Practice (DNP) scholarly projects nationally and internationally. This article shares lessons learned from five years of experience with using an institutional repository, archiving and showcasing over 100 full-text DNP projects in the collection. The aims of this article are to examine the advantages of disseminating DNP scholarly projects through an Open Access (OA) repository and to explore how items archived in OA repositories complement traditional publishing models as supplementary parts of the research ecosystem. Items from the collection have been downloaded over 72,000 times at over 3700 institutions in 182 countries around the globe. Archiving DNP projects in an OA collection can improve health care practices by augmenting the dissemination of practice outcomes in traditional peer-reviewed literature. This article provides guidance for those looking to establish and evaluate similar collections, highlighting lessons learned.

Practice scholarship satisfaction and impact as perceived by DNP-prepared nurses.

BACKGROUND: Today's health systems are complex and are challenged to strive for high-quality care that leads to optimal health outcomes. Doctor of Nursing Practice (DNP)-prepared nurses have the necessary competencies to influence health systems and delivery, that lead to safe and effective practice, by implementing practice scholarship, the translation of science to transform health care delivery, and clinical inquiry to improve practice. PURPOSE: The purpose of this study was to determine DNP-prepared nurses' satisfaction with their frequency of engagement in practice scholarship, and the relationship between the satisfaction and perceived impact of practice scholarship. METHODS: In this cross-sectional study, DNP-prepared nurses (n = 309) were recruited from a U.S. national membership organization and were asked to complete an online survey. RESULTS: Usable data findings (n = 269) revealed that 81% of participants reported feeling very, or moderately, satisfied with time spent engaging in practice scholarship or clinical inquiry in the areas of quality improvement, translation of research, and evidence-based practice; however, 19% expressed minimal satisfaction or dissatisfaction. There was a significant, moderate positive correlation between impact and satisfaction with time spent engaging in practice scholarship. CONCLUSIONS: Unclear roles and the lack of objective data measurement of practice scholarship are hindering the ability of DNP-prepared nurses to work to the full extent of their education and scope of practice. IMPLICATIONS: Further studies to develop processes and tools to measure the value and impact of DNP-prepared nurses on quality and safety, health care policies, systems, and population health are recommended.

Entrustable Professional Activities in Clinical Education: A Practical Approach for Advanced Nursing Education.

BACKGROUND: Competency attainment is foremost in the ethos of this project that provides a practical guide to implementing entrustable professional activities (EPAs) as one approach to competency acquisition in the clinical education component of a health care program. EPAs are units of work that provide evidence of required competencies for the clinical education component of a program of study for educators, preceptors, and students. PROBLEM: The American Association of Colleges of Nursing has raised the importance of competency-based education and need for a practical approach to assess clinical competency challenges (eg, EPAs) in nursing education. APPROACH: The implementation of EPAs in the clinical component of advanced nursing education is detailed as an example in this article. Prioritizing a systematic approach, the Knowledge to Action framework, was chosen to guide the process. CONCLUSION: Nursing must act now to put in place a robust competency acquisition and validation system.

Impact of Practice Scholarship as Perceived by Nurses Holding a DNP Degree.

OBJECTIVE: The aim of this study was to explore the perceived impact of practice scholarship among DNP-prepared nurses and the relationship of impact to primary work role and years since graduation. BACKGROUND: Healthcare organizations continuously seek ways to improve health outcomes and reduce cost. Doctor of Nursing Practice-prepared nurses are educated with essential competencies to lead healthcare reform initiatives based on their practice scholarship contribution. METHODS: A cross-sectional design was used to administer a self-report online survey to a convenience sample of 306 DNP graduates currently in practice. RESULTS: The highest impact of practice scholarship was perceived on patients, populations, quality of care, and the profession. The impact on policy, cost, and cost savings was significantly lower. No significant difference was found on practice scholarship impact based on role or between years of experience since graduation. CONCLUSION: Doctor of Nursing Practice competencies support practice scholarship outcomes. Organizational resources are needed to support the impact of practice scholarship.

Practice scholarship engagement as reported by nurses holding a doctor of nursing practice degree.

BACKGROUND: Nearly 15 years after the introduction of the doctor of nursing practice (DNP) degree, stakeholders anticipate practice scholarship outcomes from graduates. PURPOSE: To examine the frequency of engagement in practice scholarship, the relationship between the knowledge gained in DNP programs and the frequency of engagement in practice scholarship and the relationship between engagement in practice scholarship, work role, and years since graduation with a DNP degree, as reported by practicing nurses. METHODOLOGY: This cross-sectional study recruited 306 practicing DNP graduates via a national organization and employed an electronic survey. Descriptive and inferential statistics, correlational analysis, and a one-way analysis of variance were conducted on demographics and outcome variables for 269 completed surveys. RESULTS: The practice scholarship activity reported most frequently was evaluation of current clinical evidence and least frequently was dissemination of policy papers. Reported knowledge gained from DNP programs and frequency of engagement in practice scholarship indicate a weak positive correlation. There was a significant difference in the direct care work role and practice scholarship engagement compared with other roles, and between those practicing greater than 10 years and those with less experience. CONCLUSIONS: Results highlight the underutilization of knowledge gained in DNP programs and engagement in practice scholarship. The study emphasizes the complexity of realizing practice scholarship outcomes of DNP-prepared nurses to influence patients, populations, systems, and policy as well as the advancement of the nursing profession. IMPLICATIONS: This is a call to action for DNP graduates, academia, practice, and the nursing profession to support and value practice scholarship.

Drivers for seeking the doctor of nursing practice degree and competencies acquired as reported by nurses in practice.

BACKGROUND: The American Association of Colleges of Nursing introduced the Doctor of Nursing Practice (DNP) degree in 2004. To date, few publications examine the competencies and impact of nurses with practice doctorates. PURPOSE: The purpose of this study was to examine reasons for seeking a DNP degree, assess knowledge and competencies acquired from DNP programs, and to inform stakeholders about the skills acquired by nurses with practice doctorates. METHODS: A cross-sectional design was used to administer a self-report survey to a convenience sample of DNP-prepared nurses in practice, recruited from a national membership organization. The electronic survey was designed using constructs developed from the literature, national organization position statements, and standards of doctoral nursing education. RESULTS: A total of 306 participants responded to the survey, 270 were used after data review. The majority of respondents did not seek a DNP degree because it was required for a job, to gain additional supervised practice, or to receive additional training with a specialty population. The majority strongly agreed that they gained competency in translating and synthesizing research evidence into practice, designing and implementing quality improvement, and identifying, measuring, and evaluating outcomes. CONCLUSIONS: Primary reasons for seeking a DNP degree were seeking knowledge, skills, competencies, confidence, and job opportunities. IMPLICATIONS FOR PRACTICE: Doctor of Nursing Practice-prepared nurses hold unique, advanced knowledge, competencies and skills to affect health care across multiple settings. Study results suggest that highly skilled DNP-prepared nurses are equipped to lead quality improvement, engage in practice scholarship, and improve clinical outcomes.

Competency frameworks for nurse practitioner residency and fellowship programs: Comparison, analysis, and recommendations.

ABSTRACT: Nurse practitioner (NP) education has followed the pattern of other health professions in recent years to place an emphasis on competency-based education. In recent years, postgraduate NP residency/fellowship programs to achieve competence and successful transition to practice have emerged and flourished. Currently, there is no standard competency framework in use for NP residency/fellowship programs in the United States, despite numerous published frameworks available. This article aimed to provide a comprehensive analysis of competency frameworks for NP education and to summarize and compare the competency frameworks used in NP education and residency/fellowship programs. Recommendations were sought for standardization of these competencies to create consistent evaluation and outcome measurements. Seven competency frameworks used across NP education and residency/fellowship programs were reviewed and compared in table format. Commonalities, differences, and themes were extracted from this comparison. There were more similarities than differences between the competency frameworks; however, common themes emerged as the emphasis on patient-centered, evidence-based practice, systems-based and quality improvement, and interprofessional practice and teamwork. The American Association of Colleges of Nursing Common Advanced Practice Registered Nurse Doctoral-Level Competencies, published in 2017, provided the most current, inclusive, comprehensive, and complete set of competencies for NPs at the time of graduation; however, they have not defined a progression indicator for postgraduate NP competency evaluation. This review of the competencies emphasizes (a) the need for consistent and consensus-based standards and (b) areas that NP education and residency/fellowship programs can strengthen to assess their ability to describe observable, measurable competencies. Instruments to evaluate competencies are recommended.

Strategies for Strengthening Quality Improvement Projects in a Doctor of Nursing Practice Program.

BACKGROUND: Doctor of Nursing Practice (DNP) programs must assure that attention to safe quality healthcare is threaded throughout the curriculum and prepare students to lead quality improvement (QI) initiatives in healthcare systems. OBJECTIVE: This article illustrates the integration of implementation science, QI methods, process and evaluation tools, and faculty enrichment as strategies to strengthen QI projects in a DNP program. METHODS: A three-phased approach to implement strategies to strengthen QI projects in a DNP program and to enhance faculty engagement was undertaken. A needs assessment drove the development of strategies to strengthen QI in a DNP program. RESULTS: Outcomes of implementing strategies to strengthen QI in a DNP program showed rapid uptake of the concepts of QI process models into course content within the DNP curriculum. CONCLUSIONS: Strategies consisted of assessment of courses for gaps in QI content, faculty enrichment sessions on implementation science, QI processes and models, QI metrics and data analytics, embedding new content in the DNP program courses and the use of a rigorous evaluation tool for QI projects. IMPLICATIONS FOR NURSING: When provided with QI mentors and tools, DNP students are prepared to lead QI initiatives in healthcare systems to improve the safety and quality of healthcare.

Strategies to Reenvision Doctor of Nursing Practice Projects to Meet Organization Goals During a Pandemic.

To serve as leaders in health care, Doctor of Nursing Practice (DNP) graduates must implement an innovative DNP project that is relevant to practice organizations during a pandemic. This article discusses pivotal strategies to overcome barriers by implementing types of DNP projects that align with practice organizational goals and demonstrate practice outcomes to stakeholders. [J Contin Educ Nurs. 2021;52(2):61-63.].

The practice doctorate approach to assessing advanced nursing practice in Ireland.

AIM: To describe the practice doctorate scholarly approach to assess advanced nursing practice in Ireland to address healthcare and nursing policy initiatives. BACKGROUND: A global team from Ireland and the United States collaborated with stakeholders, using a practice doctorate approach to identify geographic healthcare needs, the current state of the education and the evolving roles of advanced nursing practice. In Ireland, current policy initiatives call for expanding the capacity for advanced nurse practitioners to meet healthcare needs in community settings. SOURCES OF EVIDENCE: Further assessment data were required from stakeholders to inform graduate nursing education to prepare advanced practice nurses to fulfil increasingly complex healthcare needs. The practice doctorate approach included review of literature, current policy and assessment with interviews, dialogue and the development of working relationships with policymakers, academics and practitioners. DISCUSSION: The current state and future vision of graduate nursing education are evolving. A force field analysis identified promoting and restraining factors to the desired state of development of the primary care advanced practice role. Relationship building with stakeholders and sharing of expertise was key to engage academia and policymakers to address identified restraining forces. Short-term outcomes included development of collaborative relationships between practice, academia and policymakers, curricular development for the primary care nurse practitioner and intentionally shared dissemination to promote community graduate nursing education. IMPLICATIONS FOR NURSING PRACTICE: This innovative practice scholarship approach was used to assess and promote advanced nursing practice impact and promote the nursing profession globally. IMPLICATIONS FOR POLICY: Successful collaboration between two global partners was achieved to promote policy objectives for both nursing and health care, with the ultimate goal of improving health outcomes and population health.

Facilitators, barriers, benefits, and funding to implement postgraduate nurse practitioner residency/fellowship programs.

BACKGROUND: A current trend to address the increasing numbers of new graduate nurse practitioners (NPs) and the expanding scope of practice of NPs is the emergence of employer-based postgraduate NP residency/fellowship programs. PURPOSE: The purpose of this study was to conduct a comprehensive examination of postgraduate NP residency/fellowship programs in the United States, to gain an understanding of the facilitators, barriers, benefits, and funding of these programs, from the perspective of the program directors. METHODS: This exploratory study used a quantitative design to conduct an online survey, developed by the researchers, of program directors of postgraduate NP residency/fellowship programs. Descriptive statistics were generated for continuous variables: the mean, SD, and minimum, and maximum values, and for categorical variables, frequency and percentage were reported. RESULTS: More than 90% of program directors indicated that NP recruitment and retention were benefits to organizations implementing NP residency/fellowship programs. Decision makers in organizations support postgraduate NP residency/fellowship programs and few barriers exist to implement programs. More than 84% indicated that physician and administrative support were facilitators to program implementation. Less than 50% of program directors identified barriers to implementation. Less than half of programs received funding sources for program implementation. IMPLICATIONS FOR PRACTICE: This study provides data and insight into the emerging industry of postgraduate NP residency/training programs and informs regulators, educators, and employers about how to maximize the facilitators, reduce and decrease barriers, identify sources of funding, and appreciate the benefits of implementing programs.

Educational characteristics and content of postgraduate nurse practitioner residency/fellowship programs.

BACKGROUND: Nurse practitioner (NP) residency/fellowship programs are an emerging industry across the country. PURPOSE: This study aimed to conduct an in-depth exploration about postgraduate NP residency/fellowship programs in the United States and to gain an understanding of program characteristics, educational content, and implementation methods to assist NPs to transition to practice. METHODS: This exploratory study used a quantitative design to conduct an online survey of program directors of NP residency/fellowship programs to collect data about program characteristics to assist graduates to transition to practice. Descriptive statistics were calculated for continuous variables, whereas frequency and percentage were calculated for categorical variables. RESULTS: Nurse practitioner residency/fellowship programs lack consistency in standards for educational content and delivery methods. Only 26% of the programs were accredited, and the programs were not consistently based on nationally recognized competencies. Ninety percent of the programs relied on didactic and clinical supervision delivery methods. More than 90% of the residents/fellows cared for adults older than 65 years of age and managed chronic diseases. Family Nurse Practitioner was the most commonly cited population track offered (73%). Nurse practitioner residency/fellowship programs are sparsely offered in the most rural states with underserved populations. IMPLICATIONS FOR PRACTICE: This study provides data and insight into the emerging industry of postgraduate NP residency/training programs for educators and employers. In addition, it informs regulators and decision makers about the quality and consistency of programs and the impact of programs on the care delivered by new graduate NPs.

Mentoring students engaging in scholarly projects and dissertations in doctoral nursing programs.

BACKGROUND: Doctor of Nursing Practice (DNP) programs in the US have grown exponentially, outnumbering Doctor of Philosophy (PhD) in Nursing programs. Faculty are mentoring increasing numbers of students on DNP projects or PhD dissertations. PURPOSE: This descriptive study explored faculty characteristics and examined support, engagement, and outcomes of American Association of Colleges of Nursing member nursing faculty mentoring student DNP projects or PhD dissertations. METHOD: A researcher-developed survey tool was emailed to 550 Deans and Program Directors of AACN doctoral programs for distribution to their doctoral faculty. Survey data were analyzed using descriptive statistics. FINDINGS: 177 DNP and 53 PhD (N=230) program surveys were completed. Faculty described challenges in the mentoring role including: time constraints, workload allocation, resources, faculty role preparation, student readiness, and variability in student outcomes. CONCLUSIONS: Additional dialogue and consensus is required to promote mentoring of students in nursing doctoral programs to ensure rigor of scholarly outcomes.

Perceived Evidence-Based Practice Competency Acquisition in Graduate Nursing Students: Impact of Intentional Course Design.

BACKGROUND: Acquisition of evidence-based practice (EBP) competencies in graduate-level nursing programs bridges the research-practice gap in professional practice. This study evaluated the impact of the Star Model of Knowledge Transformation as a framework for course design on graduate-level nursing students' perceived EBP competencies. METHOD: Data were collected from 2012 to 2017 (N = 544). Repeated-measures ANOVA was used to analyze pre- and postassessment data over time. Data were collected for each of the five stages or Star Points of EBP competencies. RESULTS: Significant postcourse improvement in perceived EBP competencies was demonstrated (p ≤ .000) for all Star Points and years. The greatest pre- and postassessment percentage change occurred in the Translation Star Point scores and the least percentage change occurred in Discovery. CONCLUSION: These data support the use of intentional course design based on a recognized EBP model to improve perceived EBP competencies in Master of Science in Nursing students. [J Contin Educ Nurs. 2019;50(2):79-86.].