DNP Assessment: A Self-Reflective Overview Q1: Integration and Application

In terms of the direct application of what I have learned over the course of my DNP studies, I feel I have grown in my ability to systematically apply nursing theory to my everyday practice. A good example of this is the concept of self-care. Like many nurses, encouraging patient self-care has been a priority, given there is a limited extent to which patients, even patients with chronic illnesses, can be maintained within a hospital setting. Orem’s self-care deficit theory suggests that nurses should intervene to rectify self-care deficits of patients when and if needed. This may be as minor as reinforcing wellness patterns for the young and healthy, as well as providing direct assistance to individuals who need medical care. Evidence-based research suggests that using Orem’s theory enhances clinical performance due to its clarity and wide applicability and also enhances patient empowerment and satisfaction. (Malekzadeh, Amouzeshi, & Mazlom, 2018). Evidence-based research provides support for why something works, how it works, and enables me as a nursing leader to make a case for using such theories in a meaningful and operational way to administrators. Changes are costly and inevitably cause disruptions in routines and standard operating procedures, and without outside support that changes will generate quality improvements, there will be greater institutional resistance.

Q2: Leadership

Although there is a greater demand for nurses within the healthcare system than ever before, there are also concerns that nurses are being increasingly overburdened with high patient loads and long shifts. When the organization is experiencing a shortage, the temptation is unfortunately to hope that nurses will be so motivated to help patients that they will ignore physical fatigue and even the fairness owned to them as employees. Once again, evidence-based research can serve to protect nurses against potentially...

There is strong evidence-based research linking excessive numbers of patients with increased rates of nursing burnout and errors, particularly given the “growing concern over a caregiver shortage occurring, due to population increases, chronic disease growth, and increased life expectancies” in the U.S. (Hall, et al., 2016, p.3). Through the use of systematic reviews and research evidence, nursing leaders such as myself can make a far better case explaining the risks of overwhelming nurses as a risk to patients and institutional reputations.
DNPs can also provide support, again using evidence-based research, for widening the scope of practice of advance-level prepared nurses. Allowing APRNs to practice to the full extent the law allows has not been shown to negatively impact patient care and can generate cost savings for the institution. There is often resistance to allowing APRNs to do so. Once again as a nursing leader I have acted as an advocate for greater liberalization on an institutional level for independent practice (Joseph & Huber, 2015). Nursing leaders must communicate the unique value that nurses can provide, with their individualized, patient-centric perspective.

I have also been an advocate for greater leadership training and continuing education for all nurses on an institutional level, so that education and training meets the needs of the contemporary healthcare system. “The challenge for clinical leadership is how to structure the knowledge, skills, and abilities required so that nurses are positioned to step into roles that are needed, yet, for which there may not yet be formal jobs” (Joseph & Huber, 2015, par.2).

Q3: Information Systems

It is often said that what cannot be measured cannot be improved. Keeping track of benchmarks such as medical errors, “inpatient mortality…utilization of procedures for which there are questions of overuse, underuse, and…