The business of Doctor of Nursing Practice (DNP) education: Practical application strategies to apply business concepts in DNP education.

PURPOSE: The purpose of this article is to 1) review updated business competencies in The Essentials: Core Competencies for Professional Nursing Education for Advanced-Level Nursing Education (2021) and 2) suggest strategies on how to integrate business and finance concepts encompassing quality, safety, and systems-based practice into DNP educational curricula. BACKGROUND: The Institute of Medicine recognizes strong nursing leadership on all system levels from "bedside to boardroom" as critical to redesigning healthcare that is affordable and accessible. The business of healthcare requires the DNP-prepared nurse to be equipped to understand and navigate business principles necessary for sustainable change to improve patient outcomes. The updated 2021 AACN Essentials include enhanced business concepts and competencies as curricular elements to prepare practice-ready DNP prepared leaders. FINDINGS: Current healthcare translation of research to practice has historically been slow, and only recently has the average time for research to translate to practice decreased from 17 years to 15 years. DNP-prepared nurses, as evidence-based practice and quality improvement experts, are positioned perfectly to reduce this research translation time gap to improve patient outcomes by implementing evidence-based change. Employers outside the academic setting, and arguably even within the academic setting, often fail to understand this unique skill set of a DNP-prepared nurse. A lack of business expertise disadvantages s the DNP-prepared nurses 'ability to effectively communicate and demonstrate the ROI and value added to an organization or interprofessional team. Achieving competency with business concepts during DNP education such as marketing, budgeting, return on investment, healthcare finance and interprofessional collaboration are critical components for a practice-ready DNP graduate as noted within the revised AACN Essentials (2021). DISCUSSION: The didactic content of business education that meets the 2021 AACN Essentials can be integrated in established DNP core courses or through creating new courses in the curriculum. Students through innovative assignments, immersion experiences, and the DNP final scholarly project can demonstrate application and competence of learned business principles. Strategically integrating business concepts into DNP curriculum provides multiple benefits to the DNP graduate, organizations, and ultimately, patients.

The state of mental health, burnout, mattering and perceived wellness culture in Doctorally prepared nursing faculty with implications for action.

BACKGROUND: Depression, anxiety, and burnout are an epidemic in the nursing profession. Unlike nurses in clinical settings, little is known about the mental health of doctorally prepared nursing faculty in academic settings, especially when separated by degree type (Doctor of Philosophy in Nursing [PhD] vs. Doctor of Nursing Practice [DNP]) and clinical or tenure track. AIMS: The study aims were to: (1) describe the current rate of depression, anxiety, and burnout in PhD and DNP-prepared nursing faculty and tenure and clinical faculty across the United States; (2) determine if differences exist in mental health outcomes between PhD and DNP-prepared faculty and tenure and clinical faculty; (3) explore whether wellness culture and mattering to the organization influence faculty mental health outcomes; and (4) gain insight into faculty's perceptions of their roles. METHODS: An online descriptive correlational survey design was used with doctorally prepared nursing faculty across the U.S. The survey was distributed to faculty by nursing deans and included: demographics; valid and reliable scales for depression, anxiety, and burnout; an assessment of wellness culture and mattering; and an open-ended question. Descriptive statistics described mental health outcomes; Cohen's d was used to determine effect sizes between PhD and DNP faculty for the mental health outcomes; and Spearman's correlations tested associations among depression, anxiety, burnout, mattering, and workplace culture. RESULTS: PhD (n = 110) and DNP (n = 114) faculty completed the survey; 70.9% of PhD faculty and 35.1% of DNP faculty were tenure track. A small effect size (0.22) was found, with more PhDs (17.3%) screening positive for depression than DNPs (9.6%). No differences were observed between tenure and clinical track. Higher perceptions of mattering and workplace culture were associated with less depression, anxiety, and burnout. Identified contributions to mental health outcomes yielded five themes: lack of appreciation, role concerns, time for scholarship, burnout cultures, and faculty preparation for teaching. LINKING EVIDENCE TO ACTION: Urgent action must be taken by college leaders to correct system issues contributing to suboptimal mental health in both faculty and students. Academic organizations need to build wellness cultures and provide infrastructures that offer evidence-based interventions to support faculty well-being.

The Doctor of Nursing Practice help desk: An innovative approach to developing evidence-based practice competency and providing DNP project support.

BACKGROUND: The 2021 American Association for Colleges of Nursing (AACN) Essentials for Professional Nursing Education identifies evidence-based practice (EBP) as a core concept meant to be integrated across curricula. Integrating EBP in Doctor of Nursing Practice (DNP) programs is challenging because of barriers including persistent confusion between research, EBP, and quality improvement; low faculty confidence and competence in their EBP skills and mentoring; increased faculty workload with growing program enrollments; and limited opportunities for students and faculty to practice EBP skills. AIMS: The aim of this initiative was to implement and evaluate an innovative education strategy to build DNP students' and faculty's EBP competency and confidence while mitigating barriers faced by DNP programs. METHODS: A DNP Help Desk was created and implemented at a large, Midwestern college of nursing with participation and support from EBP experts. Student and faculty participation were tracked, and perceptions of the help desk were evaluated. Opportunities to evolve the help desk were identified and implemented. RESULTS: Outcomes included a self-reported increase in student and faculty confidence and EBP competency, increased integration, and utilization of EBP in project work, elevated DNP project quality, and decreased demands on DNP project advisors. LINKING EVIDENCE TO ACTION: Engaging in innovative strategies aimed at increasing EBP competency and confidence may lead to increased EBP engagement and positive outcomes for students, faculty, and DNP programs.

Advancing Evidence-Based Practice Through Implementation Science: Critical Contributions of Doctor of Nursing Practice- and Doctor of Philosophy-Prepared Nurses.

PURPOSE: Describe the evolution of implementation science and the roles and potential collaborations of doctorally prepared nurses to advance implementation science in practice settings. METHODS: Review of academic preparation and areas of expertise for doctorally prepared nurses as it relates to implementation science and evidence-based practice (EBP). FINDINGS: There have been substantial gains in the number of academic programs in healthcare that include content on EBP, resulting in healthcare teams that are motivated to align practices with best evidence. Unfortunately, many EBP initiatives stall during early stages of implementation, resulting in fragmented practices and persistent gaps between evidence and practice. Implementation science aims to bridge this gap and provides a structured, science-based approach to implementation. Few healthcare teams are familiar with implementation science, and many do not incorporate knowledge from the field when implementing EBPs. Doctorally prepared nurses are in a unique position to serve as leaders in EBP implementation due to the breadth and depth of academic preparation and their pivotal roles across practice settings. CONCLUSIONS: Collaboratively aligning existing strengths of PhD and DNP prepared nurses with knowledge of implementation science can advance implementation of EBP across practice settings to effectively incorporate and sustain meaningful change to improve outcomes. LINKING EVIDENCE TO ACTION SECTION: Doctorally prepared nurses are in a unique position to advance and apply the science of implementation in practice settings. Nurse scientists can generate evidence on effective strategies and outcomes among healthcare teams to successfully integrate evidence based practices into routine care. Nurse leaders and educators can apply these findings and use an implementation science approach when leading clinical teams in evidence-based practice changes.

Social-Emotional Screening Protocol Implementation: A Trauma-Informed Response for Young Children in Child Welfare.

Adverse childhood experiences in young children result in negative outcomes as trauma affects brain development. In child welfare services, early recognition of delayed social-emotional skills and treatment referral is essential in reducing the effects of trauma. This quality improvement pilot project implemented an evidence-based social-emotional screening protocol using the Ages and Stages Questionnaire: Social Emotional-2 screening tool for very young children placed in out-of-home care through the county's child welfare system. Findings showed significant improvement in identification of children younger than 3 years with social-emotional concerns (p < .0001) and significant improvement in referral of those children positively identified (p = .0130). Ongoing use of the protocol was recommended, because it showed improved identification and referral for young children in the child welfare system with social-emotional concerns that were potentially trauma related. Further collaboration between child protective services, pediatric medical systems, and pediatric mental health systems is needed to facilitate trauma-informed care for children in the child welfare system.