Clinical Practice Nursing and DNP

Topic 1
DNP-prepared nurses are uniquely responsible for translating research into practice, creating the ideal environment in which evidence-based practice will flourish. However, resistance to change and perceptions of new clinical practice guidelines sometimes hinder the efforts of DNP-prepared nurses. Knowing that a new practice is evidence-based is not sufficient to ensure adaptation of the new practice by staff members. The DNP-prepared nurse also needs to communicate the reasons for the change in practice, provide background knowledge, and empower nurses by soliciting feedback and questions. Moreover, the DNP-prepared nurse can facilitate adaptation of new technology or techniques by simplifying them and eliminating any unnecessary steps. Research shows that when multiple steps or multiple changes are implemented at once, nurses were more skeptical of the new clinical practice guidelines (Castiglione & Ritchie, 2012). Therefore, the DNP-prepared nurse who frames the new guidelines clearly, and minimizes disruptions to nurses’ routines is more likely to achieve effective practice changes.
One example involves changes to clinical practice guidelines regarding catheters. A DNP-prepared nurse was leading the translation of research into practice. To clarify the reasons for the changes and the goals, the DNP-prepared nurse prepared an information sheet. The information sheet was printed on one page, was clear and simple, and also contained images. This information sheet also had links to the original research that prompted the change, and showed data on why the changes were necessary for reducing medical errors and promoting patient safety. The DNP-prepared nurse then held a brief, informal meeting when all nurses were able to take a break and asked them if they had any questions about implementing the new clinical practice guidelines. Questions were fielded, and the nurses were shown that the new guidelines fit in seamlessly with the other procedures taking place. Overall, the process was a success.
Topic 2
Both a PhD in nursing and a Doctor of Nursing Practice (DNP) are advanced degrees in the field of nursing. Although equally as demanding, the PhD and DNP paths include different coursework because they prepare the student for different career paths. The PhD program prepares the nurse more for clinical research—the primary evidence that informs practice. Likewise, a PhD can prepare the nurse for a role in nurse education.
The DNP is different from a PhD in that students will focus more on nursing practice and the applied sciences. While more than half of all DNP students also report an interest in a career in nurse education, a large number also envision themselves as nurse leaders who translate research into practice within specific healthcare settings (Loomis, Willard & Cohen, 2006). The DNP is a newer degree program, filling a need in the healthcare sector for evidence-based practice. A DNP-prepared nurse has the ability to influence changes at the organizational or enterprise level, thereby improving patient outcomes as well as organizational culture in healthcare institutions.
Nurses interested in performing experimental research to determine ways to improve patient outcomes may want to consider the PhD, whereas nurses interested in how to implement clinical research into clinical practice would want to consider the DNP. Future opportunities for graduates with both degrees are bright, but any nurse that desires to work with patients, or as a member of a multidisciplinary healthcare team should consider the DNP first. In fact, the American Association of College of Nursing (AACN) “recommends that the DNP should become the terminal degree for nurse practitioners,” (“DNP vs. Ph.D in Nursing: The Difference and The Future of Nursing,” 2014).



References

Castiglione, S.A. & Ritchie, J.A. (2012). Moving into action. Canadian Institutes of Health Research. http://www.cihr-irsc.gc.ca/e/45669.html
“DNP vs. Ph.D in Nursing: The Difference and The Future of Nursing,” (2014). The Sentinel Watch. 1 Oct, 2014. https://www.americansentinel.edu/blog/2014/10/01/terminal-degree-programs-what-is-the-difference-between-the-dnp-and-ph-d/
Loomis, J., Willard, B., & Cohen, J., (2006). "Difficult Professional Choices: Deciding Between the PhD and the DNP in Nursing". OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 1.